Test 4 - Rheumatoid Arthritis Meds (Josh) Flashcards
Rheumatoid Arthritis is an —– disease.
Autoimmune
Pathophysiology of RA?
Inflammation causes synovial membrane to grow, replacing cartilage and eventually fusing the join together
The hands of RA clients will have which noticeable feature?
Ulnar drift
Fingers will drift towards the Ulnar bone
Three major groups of RA meds?
- NSAIDS
- Glucocorticoids
- Disease-modifying Anti-rheumatic Drugs (DMARDs)
Which class is rapid relief an which is slower?
NSAIDs (rapid)
Glucocorticoids (rapid)
DMARDs (slower)
—- do NOT slow down the disease process.
NSAIDs
—- DO slow down the disease process.
Glucocorticoids
- but have lots of S/E so don’t want to stay on them long-term
DMARDs we talked about?
- Methotrexate
- Hydroxychloroquine
- TNF Blockers
MOA: Methotrexate
Block DHFR enzyme that converts Folic Acid into DNA, thus taking away ability to make WBCs, thus decreasing # of cytokines
S/E w/ Methotrexate:
- Nausea/Diarrhea (biggest S/E)
- GI ulceration
- decrease bone marrow
- Pneumonitis
- Hepatotoxicity
- Renal Failure
- Infection
- Severe Rash
Has 11 BBW!!!!
S/E w/ Hydroxychloroquine
- severe N/V/D if taken W/OUT Food
- Retinal Damage
Take which med w/ food?
Hydroxychloroquine
Watch for vision changes with which med?
Hydroxychloroquine
MOA: TNF Blockers
Block TNF, on elf the major cytokines of the inflammatory process
TNF Blockers we studied:
- infliximab
- adalimumab
- etanercept
All are IV or subQ
Common A/E of TNF Blockers?
- injection site reactions
- infections
Rare A/E of TNF Blockers?
- Severe Allergic Reactions (Steven’s Johnson)
- HF
- Hepatotoxicity
- Cancer
—- are drugs of first choice in treating RA b/c of their rapid onset.
NSAIDs
What periodic blood work is needed for a client taking Methotrexate?
Methotrexate Test
How often should Methotrexate be taken?
Once a week
Which S/E of Methotrexate is most likely to occur?
Nausea & Diarrhea
Which exam should a client taking hydroxychloroquine take regularly?
Exe exam
- due to the risk of retinal damage
- report any VISION CHANGES
Why check immunization status before beginning TNF-Inhibitors?
Increases risk of infections due to its immunosuppressant properties
A client taking which drug should report exposure to a communicable disease?
TNF-Inhibitor
- because of the risk for serious infections do to suppressed immune system by blocking TNF
