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NAPLEX 2022 > SYSTEMIC STEROIDS/AUTOIMMUNE CONDITIONS > Flashcards

SYSTEMIC STEROIDS/AUTOIMMUNE CONDITIONS Flashcards

1
Q

FLUDROCORTISONE MIMICS

A

ALDOSTERONE

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2
Q

MINERALOCORTICOID ACTIVITY

A

BALANCE OF WATER AND ELECTROLYTES
STABILIZES BLOOD PRESSURE

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3
Q

GLUCOCORTICOID ACTIVITY

A

ANTI-INFLAMMATORY

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4
Q

CUSHINGS SYNDROME

A

ADRENAL GLAND PRODUCES TOO MUCH CORTISOL

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5
Q

ADDISONS DISEASE

A

ADRENAL GLAND IS NOT MAKING ENOUGH CORTISOL

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6
Q

LONG TERM EFFECTS OF STEROIDS

A

PSYCHIATRIC CHANGES, HYPOTHYROIDISM
GLAUCOMA, CATARACTS
ACNE
FAT DEPOSITS IN FACE, ABDOMEN, UPPER BACK
GI BLEEDING/ULCERS
STRETCH MARKS AND EASY BRUISING
MUSCLE WASTING
DIABETES
POOR BONE HEALTH
HIRSUTISM
IRREGULAR PERIODS

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7
Q

WAYS TO REDUCE SYSTEMIC STEROID RISKS

A

ALTERNATE DAY DOSING
USE LOCAL STEROIDS
FOR GUT, USE STEROID WITH LOW SYSTEMIC ABSORPTION
USE LOWEST POSSIBLE DOSE

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8
Q

STEROIDS LEAST POTENT TO MOST
EQUIVALENT DOSES

A

CUTE HOT PHARMACISTS & OHYSICIANS MARRY TOGETHER & DELIVER BABIES
CORTISONE = 25 MG
HYDROCORTISONE = 20 MG
PREDNISONE = 5 MG
PREDNISOLONE = 5 MG
METHYLPREDNISOLONE = 4 MG
TRIAMCINOLONE = 4 MG
DEXAMETHASONE = 0.75 MG
BETAMETHASONE = 0.6 MG

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9
Q

RATIO OF METHYLPREDISOLONE TO PREDNISONE

A

4 MG : 5 MG

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10
Q

WHAT STEROID DOSE MAKES ONE IMMUNOSUPPRESSED

A

≥ 2 MG/KG/DAY OR
≥ 20 MG/DAY OF PREDNISONE FOR ≥ 2 WEEKS

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11
Q

WHAT NON SPECIFIC LAB VALUES CAN BE USED TO DETECT INFLAMMATION

A

ERYTHROCYTE SEDIMENTATION RATE (ESR)
C REACTIVE PROTEIN (CRP)
RHEUMATOID FACTOR (RF)
ANTI-NUCLEAR ANTIBODY (ANA)

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12
Q

MEDROL THERAPY PACK DOSING

A

21 COUNT OF 4 MG TABLETS

2/1/1/2
1/1/1/2
1/1/1/1
1/1/1
1/1
1

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13
Q

USE OF STRONG IMMUNOSUPPRESSANTS CAN INCREASE THE RISK OF

A

REACTIVATION OF TB, HEP B AND HEP C
VIRUSES
LYMPHOMAS OR SKIN CANCERS
INFECTIONS

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14
Q

CLINICAL PRESENTATION OF RHEUMATOID ARTHRITIS

A

BILATERAL SYMMETRICAL
MORNING STIFFNESS
JOINT SWELLING
PAIN
BONE DEFORMITY

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15
Q

WHAT LAB TESTS CAN BE USED TO IDENTIFY RHEUMATOID ARTHRITIS

A

ACPA
RF

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16
Q

REGARDLESS OF SEVERITY, SYMPTOMATIC RA SHOULD BE STARTED ON

A

DMARD TO SLOW DISEASE PROCESS AND PREVENT FURTHER JOINT DAMAGE

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17
Q

WHAT IS THE PREFERRED INITAL THERAPY FOR RA

A

METHOTREXATE

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18
Q

STEROID USE IN RA

A

LOWEST DOSE POSSIBLE FOR THE SHORTEST DURATION

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19
Q

MTX DOSING FOR RA

A

7.5 - 20 MG ONCE WEEKLY

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20
Q

TRADITIONAL NON-BIOLOGIC DMARDS IN RA

A

METHOTREXATE
HYDROQXYCHLOROQUINE
SULFASALAZINE
LEFLUNOMIDE
JAK INHIBITORS

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21
Q

HYDROXYCHLOROQUINE WARNING

A

IRREVERSIBLE RETINOPATHY
CARDIOMYOPATHY, QT PROLONGATION

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22
Q

SULFASALAZINE CONTRAINDICATION

A

SULFA OR SALICYLATE ALLERGY

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23
Q

LEFLUNOMIDE BOXED WARNING

A

DO NOT USE IN PREGNANCY
HEPATOTOXICITY

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24
Q

LEFLUNOMIDE ACCELERATED DRUG ELIMINATION OPTIONS

A

PURPOSE: TO REMOVE ACTIVE METABOLITE
CHOLESTYRAMINE
ACTIVATED CHARCOAL

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25
LEFLUNOMIDE AND PREGNANCY
MUST HAVE NEGATIVE PREGNANCY TEST USE 2 FORMS OF BIRTH CONTROL DURING TREATMENT MUST WAIT 2 YEARS AFTER DC OR USE ACCELERATED DRUG ELIMINATION TO BE PREGNANT
26
JAK INHIBITOR AGENTS
TOFACTINIB BARICITINIB UPADACITINIB
27
JAK INHIBITORS BOXED WARNING
SERIOUS INFECTIONS MALIGNANCY THROMBOSIS
28
CAN JAK INHIBITORS BE USED WITH BIOLOGIC DMARDS
NO
29
ANTI-TNF BIOLOGIC DMARDS
ETANERCEPT (ENBREL) ADALIMUMAB (HUMIRA) INFLIXIMAB (REMICADE) CERTOLIZUMAB (CIMZIA) GOLIMUMAB (SIMPONI)
30
WHICH ANTI-TNF BIOLOGICS NEED TO BE USED WITH MTX
REMICADE SIMPONI
31
ENGREL DOSING FREQUENCY
WEEKLY
32
HUMIRA DOSING FREQUENCY
EVERY OTHER WEEK
33
REMICADE ADMINISTRATION
IV
34
CIMZIA DOSING FREQUENCY
EVERY OTHER WEEK
35
SIMPONI DOSING FREQUENCY
MONTHLY
36
REMICADE WARNINGS
INFUSION REACTIONS DELAYED HYPERSENSITIVITY
37
ANTI-TNF BOXED WARNINGS
SERIOUS INFECTIONS, SCREEN FOR LATENT TB MALIGNANCIES
38
ANTI-TNF WARNINGS
DEMYELINATING DISEASE HEP B REACTIVATION HF HEPATOTOXICITY LUPUS-LIKE REACTION
39
RITUXIMAB (RITUXAN) MOA
ANTI-CD 20 B CELLS
40
RITUXAN ADMINISTRATION
IV WITH MTX PREMEDICATION WITH STEROID, APAP, ANTIHISTAMINE
41
CLINICAL PRESENTATION OF SLE
FATIGUE, DEPRESSION ANOREXIA, WEIGHT LOSS, MUSCLE PAIN BUTTERFLY RASH PHOTOSENSITIVITY JOINT PAIN, STIFFNESS
42
KEY DRUGS THAT CAN INDUCE LUPUS ERYTHEMATOSUS
MY PRETTY MALAR MARKING PROBABLY HAS A TRANSIENT QUALITY METHIMAZOLE PTU METHYLDOPA MINOCYCLINE PROCAINAMIDE HYDRALAZINE ANTI-TNF TERBINAFINE ISONIAZID QUINIDINE
43
LAB FINDINGS IN SLE
POSITIV ANA ANTI-SSDNA AND-DSDNA
44
SLE DRUG TREATMENT
HYDROXYCHLOROQUINE CYCLOPHOSPHAMIDE AZATHIOPRINE MYCOPHENOLATE CYCLOSPORINE
45
BELIMUMAB (BENLYSTA) USE
SLE BY REDUCE ACIVITY OF B-CELL MEDIATEDD IMMUNITY AND AUTOIMMUNE RESPONSE
46
BELIMUMAB (BENLYSTA) WARNINGS
SERIOUS INFECTIONS DO NOT GIVE WITH OTHER BIOLOGIC DMARDS OR LIVE VACCINES
47
CALCINEURIN INHIBITOR WARNINGS
INFECTIONS, MALIGNANCIES NEPHROTOXICITY, HTN
48
MULTIPLE SCLEROSIS PRESENTATION
FATIGUE NUMBNESS BLURRED VISION DETERIORATION OF COGNITIVE FUNCTION MUSCLE SPASMS PAIN INCONTINENCE GAIT INSTABILITY
49
DMARD FOR MS
INTERFERON BETA FORMULATIONS GLATIRAMER ACETATE
50
COPAXONE MOA
GLATIRAMER ACETATE IMMUNE MODULATOR
51
COPAXONE DOSING FREQUENCY
SC DAILY OR SC 3 TIMES/WEEK
52
COPAXONE WARNINGS
CHEST PAIN
53
COPAXONE SIDE EFFECTS
INJECTION SITE REACTION FLUSHING DIAPHRESIS DYSPNEA
54
WHICH AGENT IS PREFERRED FOR MS IN PREGNANCY
COPAXONE
55
INTERFERON BETA PRODUCTS
AVONEX, REBIF PLEGRIDY BETASERON, EXTAVIA
56
AVONEX DOSING VS REBIF DOSING
IM WEEKLY VS SC 3X/WEEK
57
INTERFERON BETA PRODUCT WARNINGS
PSYCHIATRIC DISORDERS INJECTION SITE NECROSIS ↑LFT THYROID DYSFUNCTION
58
SPHINGOSINE 1-PHOPHATE RECEPTOR MODULATORS CONTRAINDICATION
ARRYTHMIAS AND OTHER CV CONDITIONS OZANIMOD: USE WITH MAOI SIPONIMOD: CYP2C9*3/*3
59
SPHINGOSINE 1-PHOPHATE RECEPTOR MODULATORS WARNINGS
SLOW HR SHOULD MONITOR FOR 6 HOURS AFTER FIRST DOSE ECG REQUIRED AT BASELINE MACULAR EDEMA (NEED EYE EXAMS)
60
NATALIZUMAB (TYSABRI) MOA
MONOCLONAL ANTIBODY BINDS TO INTEGRINS ON LEUKOCYTES
61
TYSARBI BOXED WARNING
PML ONLY AVAILABLE THROUGH REMS PROGRAM
62
WHICH DRUGS CAN WORSEN RAYNAUD'S
BETA BLOCKERS BLEOMYCIN, CISPLATIN SYMPATHOMIMETICS, AMPHETAMINES, SUDOFED, ILLICIT DRUGS
63
RAYNAUD'S PREVENTION AND TREATMENT
CCB NIFEDIPINE
64
MYASTHENIA GRAVIS SYMPTOMS
CHANGES TO EYES/VISION DROOPING EYELID (PTOSIS)
65
WHAT DRUGS CA WORSEN MYASTHENIA GRAVIS
ABX: AMINOGLYCOSIDE AND QUINOLONES MG SALTS ANTIARRHYTHMICS BB AND CCB ANTIPSYCHOTICS MUSCLE RELAXANTS LOCAL ANESTHETICS
66
MYASTHENIA GRAVIS TREATMENT
CHOLINESTERASE INHIBITORS - BLOCK THE BREAKDOWN OF ACh, IMPROVING TRANSMISSION AND INCREASE MUSCLE STRENGTH
67
SJOGRENS CHARACTERISTICS
DRY EYES AND DRY MOUTH
68
SJOGRENS TREATMENT
CYCLSPORINE EYE DROPS (RESTASIS)

NAPLEX 2022 (37 decks)

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