DMARDS - Treatment of Rheumatoid Arthritis Flashcards Preview

Musculoskeletal/Rheumatic > DMARDS - Treatment of Rheumatoid Arthritis > Flashcards

Flashcards in DMARDS - Treatment of Rheumatoid Arthritis Deck (19):
1

Firstline therapy for rheumatoid arthritis

Methotrexate (maybe with NSAID or corticosteroid)

2

MOA of methotrexate

Inhibition of AICAR transformylase; increased adenosine concentrations

3

Side effects of MTX

Myelosuppression, Cat X pregnancy, pulmonary toxicity; get CBC, LFT, renal analysis

4

MOA of sulfasalazine

Inhibitor of prostaglandins and leukotrienes

5

Side effects of sulfasalazine

Blood dyscasias; get CBC, LFT, renal analysis

6

MOA of Leflunomide

Inhibits dihydroorotate dehydrogenase (pyrimidine synthesis); cell cycle blocker

7

Side effects of leflunomide

Bone marrow dysplasia, immunodeficiency, Cat X pregnancy; need CBC, LFT, pregnancy test, serum electrolytes

8

MOA of hydroxychloroquine

Increase intracellular pH; reduced number of peptide-MHC II complexes

9

Side effects of hydroxychloroquine

Contraindicated in ocular disease - corneal opacities, keratopathy, retinopathy; CNS toxicity - ototoxicity, seizures; need CBC and opthalmalogic exam

10

Biologic DMARDS

Abatacept, adalimumab, anakinra, certolizumab, etanercept, golimumab, infliximab, rituximab, tocilizumab

11

Which biologic DMARDS are TNF-alpha inhibitors?

Adalimumab, Certolizumab, etancercept, golimumab, infliximab

12

Target of rituximab?

CD20 receptor on B cells

13

MOA of Abatacept

CTLA4 - precents T cell co-stimulation via CD28

14

Side effects of biologic DMARDS?

Immunosuppression (infections, URTIs, don't give vaccines), increased risk of malignancies

15

Contraindication of infliximab?

CHF, hypotension/angina/dysrhythmia

16

Rare side effect of rituximab?

SJS/TEN

17

Avoid pregnancy with this biologic...

Rituximab

18

Blood dyscrasias in which biologics?

(CART) Certolizumab, Anakinra, Rituximab, Tocilimumab

19

Lupus-like syndrome in which biologics?

(ACEI) Adalimumab, Certolizumab, Etanercept, Infliximab