Therapies For RA

Question 1

What is point of DMARDs?

Answer 1

Slow the clinical and radio graphic progression of RA

Question 2

Targeted synthetic DMARDs?

Answer 2

JAK inhibitorsL tofacitinib

Baricitinib

Question 3

Synthetic DMARDs?

Answer 3

MTX, sulfasalazine, hydroxychloroquine, leflunomide

Question 4

Biological agents?

Answer 4

TNF blockers

Drugs targeting IL 1 IL6 B cells and T cells

Question 5

Methotrexate increase?

Answer 5

Adenosine level, anti inflammatory

Question 6

Methotrexate induced the apoptosis of?

Answer 6

CD4/8

Question 7

What are side effects of DMARDs?

Answer 7

Risk of infections
Hepatoxicity
Kidney toxicity
Headache

Question 8

Side effect of hydroxychloroquine?

Answer 8

Accumulation of drug in eye e.g Retinal pigment epithelium atrophy

Question 9

What is side effect of leflunomide?

Answer 9

Hypertension

Question 10

Tofacitinib role?

Answer 10

Selectively inhibits JAk1 and JAK 3

Used for psoriatic arthritis
UC

Question 11

Baricitinib role?

Answer 11

Selectively and reversible inhibits JAK 1 and 2

Question 12

Adverse effects of synthetic targeted DMARDs?

Answer 12

Increased risk of infection, fatigue fever, GI problems, thrombocytosis, herpes zoster

Question 13

Research in biological study showed?

Answer 13

Anti TNF alpha antibody reduced IL 1 production

Question 14

Il8 help with?

Answer 14

Leukocyte adhesion and diapedesis

Question 15

IL6 helps with?

Answer 15

Cartilage degradation

Question 16

Which are the TNF blockers?

Answer 16

Infliximab etanercept, adalimumab

Question 17

Which drug is a monoclonal antibody against B cells?

Answer 17

Rituximab

Question 18

Which is IL 1R antagonist?

Answer 18

Ankinra

Question 19

Etanercept?

Answer 19

TNF receptor. Reduces accessible TNF

Question 20

Certolizumab pegol?

Answer 20

No Fc portion attached to polyethylene glycol to reduce immunogenicity, prolong circulatory time

Question 21

ANTi TNF therapy, side effects

Answer 21

Increased risk of infections TB

Live vaccines

Question 22

What percent of RA patients don’t respond to ANTi- TNF medication/ MTX?

Answer 22

30

Question 23

Rituximab- B cell depleting agent does what?

Answer 23

Opsonises B cells so

1. Complement mediated toxicity
2. Antibody dependent cell mediated cytotoxicity/ phagocytosis
3. Apoptosis

Used for SLE

Question 24

Abatacept role?

Answer 24

Prevents costimulation, competitive inhibitor of CD28, binds CD80

Question 25

Adverse effects of biologics?

Answer 25

increased risk of infections

Not advised on:

Avoid live vaccines

Hypertension

Allergic reactions