Week 11: Rheumatoid arthritis meds

Question 1

methotrexate MOA

Answer 1

Folic acid antagonist
(take folic acid supplements)
Affect leukocyte suppression, decreasing inflammation = immunologic byproducts

Question 2

when does methotrexate take effect? what to take with it?

Answer 2

3-8 weeks for full

take NSAIDs or prednisone in the mean time

Question 3

methotrexate c/c

Answer 3

NO PREG!!!!!

MANY BBW’s!!!!:
hepatotoxicity, bone marrow suppression, GI toxicity, active stomatitis, dermatology reactions, opportunistic infections (get baseline CBC, BNP, LFTs)

Question 4

biologic DMARDS (TNF inhibitors) MOA/ind

Answer 4

rituximab (Rituxan), abatacept (Orencia)
-MOA: binds to TNF-alpha, making it inactive = reduces TNF effect = reduce infiltration of inflammation cells into join

ind: antirheumatic

Question 5

rituximab (Rituxan), abatacept (Orencia) c/c

Answer 5

caution in new infections/recurrent infections

live immunizations give 3 months before & 3 months after taking med