bDMARDS and tsDMARDS Flashcards

(36 cards)

1
Q

What is the Targeted Synthetic DMARD?

A

Tofacitinib

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2
Q

What is the tsDMARD?

A

Tofacitinib

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3
Q

What are the 7 Biologic DMARDS?

A
Etanercept
Adalimumab
Infliximab
Rituximab
Abatacept
Tocilizumab
Anakinra
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4
Q

What are 3 TNF alpha Antagonists?

A

Etanercept
Adalimumab
Infliximab

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5
Q

What is a B cell depleter mAb?

A

Rituximab

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6
Q

What drug (-) T cell activation?

A

Abatacept

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7
Q

What is an IL-6 Receptor mAb?

A

Tocilizumab

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8
Q

What is an IL-1 Antagonist?

A

Anakinra

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9
Q

bDMARDS should NEVER be combined with?

A

Each other!

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10
Q

Generally what is good and bad about bDMARDS?

A

Faster and stronger response

More expensive and risk of more severe adverse effects

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11
Q

What are the adverse effects of TNF alpha Antagonists (2)?

A

Severe allergic reactions

Serious infections like TB

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12
Q

What TNF alpha Antagonist involves 2 p75 TNF receptors bound to Fc portion of IgG?

A

Etanercept

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13
Q

How is Etanercept given?

A

1x/week via SubQ

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14
Q

What TNF alpha Antagonist is a chimeric mAb?

A

Infliximab

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15
Q

How is Infliximab given?

A

1x/ every 8 weeks via IV

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16
Q

What TNF alpha Antagonist is a human mAb?

17
Q

How is Adalimumab given?

A

1x/ every 2 weeks via SubQ

18
Q

Which TNF alpha Antagonist has a lower risk of anti-drug antibody formation?

19
Q

What is the MOA for Rituximab?

A

Antibody that targets CD20 on pre-B cell surface so that CD20 is lost as B cells differentiate into plasma cells

20
Q

If what things are present, will there be a greater likelihood of response to Rituximab?

A

Rheumatoid factor

Anti-cyclic Citrullinated Peptide antibodies

21
Q

What is a possible adverse effect with Rituximab?

A

Infusion hypersensitivity reactions

22
Q

What is the MOA for Abatacept?

A

Prevents CD28 from binding to CD80/CD86

= (-) T cell activation

23
Q

What is the possible adverse effect of Abatacept?

A

Serious infections

24
Q

Tocilizumab is an Anti-IL-6 Receptor Antibody. What forms does it target?

A

Membrane bound and soluble IL-6 receptors

25
What is the effective result of Tocilizumab targeting IL-6 Receptors?
Limits hepatic acute phase response and activation of T/B cells, macrophages and osteoclasts
26
What are 2 possible adverse effects of Tocilizumab?
Upper respiratory tract infections | Life threatening infections
27
Anakinra is an IL-1 Antagonist. How often is it used?
Rarely used - less efficacious
28
What are 2 possible adverse effects of Anakinra?
Serious infections | Hypersensitivity reactions
29
How do tsDMARDs differ from bDMARDS?
Small molecules, NOT proteins
30
How is Tofacitinib given that is generally different from most DMARDS?
ORALLY
31
What is the MOA for Tofacitinib and the effect it causes?
JAK3 Antagonist | ==> (-) production of IL-17, IFNgamma and CD4 T cells
32
What are the adverse effects associated with Tofacitinib?
Serious infections with opportunistic pathogens Increased malignancies Cardiovascular warnings
33
What are the adverse effects associated with Tofacitinib?
Serious infections with opportunistic pathogens Increased malignancies Cardiovascular warnings
34
Once Methotrexate has been tried, what bDMARD should be added?
TNF alpha Antagonists
35
Tofacitinib can be used with or without Methotrexate. It is a first choice after what?
csDMARDS
36
Once Methotrexate + TNF alpha Antagonists have been tried and they were not successful, what should then be tried?
Methotrexate + NON-TNF bDMARD or tsDMARD