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Rx Prep Chapters >4 hours > Systemic Steroids & Autoimmune > Flashcards

Systemic Steroids & Autoimmune Flashcards

1
Q

what are the long term efffects of steroids

A

fat deposits: buffalo hump, moon face
diabetes
women only: hirtuism\
stetch marks
growth retardation
impaired wound healing
poor bone health
GI bleeding
cushings disease
glaucoma, Cataracts
psychiatric changes: hypothyroidism

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2
Q

Glucocorticosteroids
contraindications
warning
short term side effects (<1month)

A

CI: Live vaccines serious systemic infections
W: adrenal suppression, must Taper slowly

increase appetite
WG
emotional instability

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3
Q

systemic steroid PO-IV dose equivalence

A

Cortisone 25
Hydrocortisone 20
Prednisone 5
Prednisolone 5
Methylprednisolone 4
Triamcinolone 4
Dexamethasone 0.75
Beclomethasone 0.6

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4
Q

dexmethasone

A

Dexpak
Decadron

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5
Q

hydrocortisone

A

Solu-cortef

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6
Q

prednisone

A

Deltasone

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7
Q

prednisolone

A

Millipred
OrapredODT

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8
Q

triamcinolone

A

kenalog

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9
Q

cortisone

A

no brand

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10
Q

autoimmune disease labs to review & symptoms

A

weakness, fatigue, and pain
ESR, CRP, RF, ANA

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11
Q

what can occur when taking immunosuppresants

A

re-activation of TB and Hep B & C must be tested and treated
viruses: must be given prior
Lymphomas
Infections

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12
Q

symptoms of rhematoid arthritis

A

joint swelling, pain, stiffness, bone deformity, redness, difficulty moving

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13
Q

RA can be found with what labs

A

RF rheumatoid factor
ACPA anti-citrullinated antibody

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14
Q

drug treatment for RA

A

non-biologic DMARD (first line)
(P) MTX
or
combo DMARD or TNF biologic or Non TNF biologic

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15
Q

Non-Biologic DMARDs

A

methotrexate (Trexall)
hydroxychloroquine (Plaquenil)
Sulfasalazine (Azulfidine)
leflunomide (Arava)

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16
Q

Janus Kinase Inhibitor

A

stimulate immune cell function
Tofacitinib (Xelijanz)
Baricitinib (Olumiant)

Upatacitinib (Rinvoq)

cause thrombosis, Malignancy, serious infection including TB

Cannot be used with other biologic DMARD

17
Q

Anti-TNF Biologic DMARD
boxed warning
warnings

A

certolizumab (Cimzia)
adalimumab (Humira)
Golimumab (Simponi)
Etanercept (Enbrel)
Infliximab (Remicade)

serious infection - screen for latent TB & treat

DNU biologic DMARD/live vaccines
cause demyelinating disease, Hep B reactivation,
Heart Failure
Hepatotoxic, Lupus-like syndrome

18
Q

methotrexate for RA
boxed warning
contraindication
monitoring parameter

A

7.5 mg- 20mg once weekly (PO,SC,IM)
Hepatoxicity
myelosuppression
mucositits/stomatoitis
CI: pregnancy
CBC, LFTs, chest x-ray, hepB & hepC serologies

19
Q

hydroxychloroquine
warnings

A

irrevesible retinopathy

20
Q

sulfazalazine
contraindicated

A

sulfa allergy
can cause yellow/orangeskin/ urine

21
Q

leflunomide
bowed warning
contraindication

A

Hepatotoxicity
pregnancy

22
Q

methotrexate drug interactions

A

should NOT be taken with alcohol
if taken with NSAID/ ASA/ Betalactams/probenecid results in mtx toxicity
avoid with cyclosporine lead to toxic levels

23
Q

Biologic DMARD Non TNF
(use other MOA other than TNF)

A

Rituximab (Rituxan)- depletes CD20 B cells
Anakinra (Kineret)
Abatacept (Orencia)
Tocilizumab (Actemra)
Sarilumab (Kevzara)

24
Q

drugs that cause Drug induce Lupus Erythematosus

A

PITA PMMHQ M
Propylthiouracil
Isoniazid
Terbinafine
Anti-TNF (5)
Procainamide
Minocycline
Methimazole
Hydralazine
Quinidine
Methyldopa

25
Q

systemic lupus signs
labs
drug treatment

A

butterfly rash
fatigue, depression, anorexia, muscle pain
ANA, antissDNA, antidsDNA

hydroxychloroquine
cyclophosphamide
azathioprine
mycophenolate mofetil
cyclosporine

26
Q

lupus nephritis treatment drug FDA approved

A

Belimumab (Benlysta)
cannot be given with other biologic DMARD

27
Q

multiple sclerosis treatment

A

Glatiramer acetate (Copaxone)
or
Pegylated interferon beta 1a (Pledridy)

28
Q

Glatiramer acetate (Copaxone) - SC
warning & SE

A

chest pain
injection site reactions
flushing, diaphoresis, dyspnea

29
Q

Pegylated interferon beta 1a (Pledridy)

A

psychiatric disorders (depression/suicide)
injection site necrosis
increases LFTS
thyroid dysfunction
flulikesymtoms

30
Q

monoclonal antibodies

Natalizumab

A

Tysarbi

boxed warning:
progressive multifocal leukoencephalopathy

31
Q

raynauds syndrome drug treatment

A

CCB nifedipine

drugs that worsen:
BB, bleomycin,cisplatin, amphetamines

Rx Prep Chapters >4 hours (6 decks)

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