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DMARDS + Gout Flashcards

1
Q

DMARDS take effect after ____ how many weeks/months of treatment

A

6 weeks to 6 months

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2
Q

___ inhibits AICAR transformylase AND thymidilate synthetase

A

Methotrexate

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3
Q

___ has a secondary effect on polymorphonuclear chemotaxis;

play a role in Wegener granulomatosis, Giant cell arteritis, vasculitis, dermatomyositis

A

Methotrexate

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4
Q

What is the DMARD of first choice in RA?

A

methotrexate

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5
Q

What is the rescue agent of methotrexate?

A

Leucovorin

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6
Q

Cite examples of TNF alpha inhibitors

A
  1. Adalimumab
  2. Certolizumab
  3. Etanercept
  4. Golimumab
  5. Infliximab
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7
Q

TNF alpha inhibitors are used in what diseases?

A

Crohn’s

RA

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8
Q

___ is a DMARD that forms 6-thioguanine, suppressing inosinic acid synthesis, Bcell and T cell function, Ig production, and IL2 secretion

A

Azathioprine

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9
Q

What antigout treatment is contraindicated with concommitant azathioprine therapy?

A

Allopurinol

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10
Q

When Azathioprine and Allopurinol are given simultaneously, what by product is bound to increase?

A

6 thioguanine nucleotides

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11
Q

A DMARD that suppresses Tlymphocytes to mitogens, decrease leukocyte chemotaxis, stabilize lysosomal enzymes, inhibit DNA and RNA synthesis, and trap free radicals

A

Chlorquine

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12
Q

Aside from malaria, Chlorquine/Hydrochlorquine is used in what diseases?

A

RA
SLE
Sjogren Syndrome

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13
Q

___ is a cancer chemotherapeutic drug that forms phosphoramide mustard leading to cross-linking of DNA to prevent cell replication

A

Cyclophosphamide

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14
Q

What is the rescue agent of cyclophosphamide?

A

MESNA

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15
Q

___ inhibits IL1 and IL2 receptor production AND secondarily inhibits macrophage Tcell interaction and T cell responsiveness

A

cyclosporine

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16
Q

What is the active product of mycophenolate mofetil?

A

Mycophenolic acid

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17
Q

___ inhibits inosine monophosphate dehydrogenase

A

mycophenolic acid

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18
Q

What is the enzyme that plays a role in guanine nucleotide synthesis?

A

Monophosphate dehydrogenase

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19
Q

This DMARD causes reversible myelosuppresion (neutropenia)

A

mycophenolate mofetil

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20
Q

What is the active metabolite of sulfasalazine?

A

sulfapyridine

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21
Q

The active metabolite of this drug inhibits the release of inflammatory cytokines

A

Sulfasalazine

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22
Q

What autoantibody is formed in sulfasalazine therapy?

A

anti-dsDNA

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23
Q

This DMARD causes reversible infertility in men

A

Sulfasalazine

24
Q

____ is a co-stimulator modulator. Inhibits the activation of Tcells by binding to CD80 and 86 of the APC

A

Abatacepts

Concomitant use of TNF alpha blocker is not recommended due to increased risk of infection

25
___ is a non-biologic DMARD that inhibits dihydroorotate dehydrogenase leading to arrest of stimulated cells in the G1 phase of cell growth
Leflunomide
26
What is the active metabolite of leflunomide which is converted in the intestines?
A77-1726
27
This non-biologic DMARD is considered as effective as Methotrexate in treating RA
Leflunomide
28
A monoclonal antibody that deplete B cells by cell-mediated and complement dependent cytotoxicity and stimulation of cell apoptosis
Rituximab
29
This can be used in moderate to severe RA (with MTX) in patients with INADEQUATE response to TNF alpha
Rituximab
30
This MAB binds to IL6 to d decrease Tcell activation acnd inflammatory process
Tocilizumab
31
Prior to giving tocilizumab, patient should be screened for what disease entity?
Tuberculosis
32
This MAB is not advised for patients with what disease of the large intestine?
diverticulitis
33
___ inhibits macrophage function, inhibits macrophage function, decreases IL-1, decreases rheumatoid factor and prevents collagen from cross-linking
Penicillamine
34
Wha is the JAK inhibitor used to treat RA
Tofacitinib
35
___ is a sphingosine-1-phosphate receptor modulator used for multiple sclerosis
Fingolimod
36
__ is a MAB against IL17 used for psoriasis and ankylosing spondylitis
Secukinumab
37
__ is a MAB against IL2 used to prevent organ transplant rejection
Basiliximab
38
___ ius a MAB against IL12 and IL23; used for crohns and psoriasis
Utsekinumab
39
____antigout treatment that inhibits microtubule assembly and LTB4 production
Colchicine
40
What is the drug of choice for familial mediterranean fever?
colchicine
41
Gout treatment that can cause aplastic anenia, peripheral neuritis, and myopathy
Colchicine
42
What NSAIDs also inhibit urate crystal phagocytosis?
indomethacin
43
Antigout drug that is uricospric
Probenecid
44
Probenecid competes with uric acid reabsorption in which part of the nephron?
proximal tubules
45
Uricosoric and antigout agent that can cause nephrotic syndrome
probenecid
46
Probenecid is advantageous in prolonging the therapeutic effect of this antibiotic by inhibiting its renal tubular secretion
penicillin
47
what is the minimum GFR prior to starting probenecid
30 mL/min
48
Cite examples of urocosuric drugs
1. Fenofibrate 2. Losartan 3. Probenecid
49
What metabolite of allopurinol that irreversibly inhibits xanthine oxidase?
Alloxanthine
50
Allopurinol cant be given with this antichemo drug
Azathioprine
51
___ is a nonpurine reversible inhibitor of xanthine oxidase
febuxostat
52
What is the first line treatment for chronic gout?
allopurinol
53
What is the treatment for allopurinol intolerance?
febuxostat
54
___ is derived from mamalian urate oxidse enzyme which converts uric acid to allantoid
Pegloticase
55
Cite examples of IL-1 pathway inhibitors that are used for acute gout in patients with contraindication or refractory to traditional therapies
1. Anakinra 2. Canakinumab 3. Rilonacept

Pharmacology (35 decks)

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