Drugs for Skeletal System

Question 1

What drug is a monoclonal antibody that binds to TNF-alpha; given by IV with methotrexate; associated with upper respiratory infections; used for the treatment of RA; chimeric

Answer 1

Infliximab

Question 2

Drug that is an inhibitor of dihydrofolate reductase; used for the treatment of RA

Answer 2

Methotrexate

Question 3

What are the side effects of Methotrexate?

Answer 3

1) Immunosuppresion
2) Nausea
3) Mucosal ulcers
4) Cirrhosis
5) Pneumonitis

Question 4

What side effect of methotrexate does not go away when drug is removed?

Answer 4

Pneumonitis

Question 5

Drug that is a recombinant protein consisting of two soluble portions of TNF-alpha receptor molecule with a Fc portion of IgG; binds to TNF-alpha; injected

Answer 5

Etanercept

Question 6

What is a problem that may occur with infliximab?

Answer 6

1) Inflixmab is a chimer monoclonal antibody that may cause a hypersensitivity reaction within the body

Question 7

Human monoclonal antibody for anti-TNF; injected

Answer 7

Adalimumab

Question 8

What is given as an alternative to methotrexate? What are its side effects?

Answer 8

1) Leflunomide

2) Elevated liver enzymes

Question 9

Drug that acts by inhibiting the activation of T cells by binding to the CD 80/86; used if anti-TNF does not work

Answer 9

Abatacept

Question 10

When is abatacept contraindicated?

Answer 10

1) COPD

2) Given with anti-TNF

Question 11

MOA of Leflunomide

Answer 11

1) Inhibitor of tyrosine kinase

2) Inhibitor of pyrmidine synthesis

Question 12

Monoclonal antibody for CD20 on B cells

Answer 12

Rituximab

Question 13

Drug that is poorly absorbed and is broken down by intestinal bacteria into a salicylate and an antibiotic; risk for hypersensitivity

Answer 13

Sulfasalazine

Question 14

What are the adverse effects of hydroxychloroquine?

Answer 14

1) Corneal deposits
2) Extraocular muscle weakness
3) Loss of accommodation
4) Retinopathy

Question 15

Drugs that work by inhibiting the maturation and function of mononuclear phagocytes and T cells

Answer 15

Gold Salts

Question 16

What gold salts are water soluble and can be given IM injection; generally are given as weekly injections until 1 gm has been administered

Answer 16

1) Gold Sodium thiomalate

2) Aurothioglucose

Question 17

What gold salt is hydrophobic and is given orally for 6-9 months; less efficacy

Answer 17

Auranofin

Question 18

What is the most common side effect of gold salts?

Answer 18

Lesions of the skin and mucosal membranes

Question 19

Drug that is an analog to cysteine that slows the bone destruction of RA

Answer 19

D-penicillamine

Question 20

What are the side effects of D-penicillamine?

Answer 20

1) Dermatological problems
2) Nephritis
3) Aplastic anemia

Question 21

Recombinant form of IL-1ra that is used to inhibit the effects of IL-1 (inhibition of collagen synthesis and increased joint degradation)

Answer 21

Anakinra

Question 22

Antibody selective for the IL-6 receptor

Answer 22

Tocilizumab

Question 23

What are the side effects of Tocilizumab?

Answer 23

1) Upper respiratory infections
2) Headache
3) Elevated BP
4) Increased LDL
5) Increases risk for cancer

Question 24

Drug that causes the local depletion of substance P

Answer 24

Capsaicin

Question 25

Alkylating agent that causes inhibition of DNA syntesis

Answer 25

Cyclophosphamide

Question 26

Purine antimetabolite that interferes with purine synthesis and causes DNA damage through formation of false nucleotide substrates

Answer 26

Azathioprine

Question 27

What are the side effects of azathioprine?

Answer 27

1) Bone marrow suppression | 2) Hepatotoxicity

Question 28

Isolated cyclic peptide from fungus that inhibits T cells

Answer 28

Cyclosporine

Question 29

What drugs increase the excretion of uric acid from the body?

Answer 29

1) Probenecid | 2) Sulfinpyrazone

Question 30

What drugs are selective inhibitors in the terminal step of uric acid (aka xanthine oxidase inhibitors)

Answer 30

1) Allopurinol | 2) Febuxostat

Question 31

What drug decreases the mobility of granulocytes by binding to tubulin?

Answer 31

1) Colchicine

Question 32

What NSAID is the drug of choice for acute gout attacks?

Answer 32

Indomethacin

Question 33

Why is allopurinol started at low doses first? What is usually given with allopurinol?

Answer 33

1) Because it precipitates acute attacks | 2) Colchicine

Question 34

What type of dose of a uricosuric drug should be given to increase excretion of uric acid? High or low?

Answer 34

1) High | 2) Low doses decrease the excretion of uric acid

Question 35

MOA of Allopurinol

Answer 35

Inhibits xanthine oxidase resulting in decreased production of uric acid

Question 36

What drug acts similarly to Allopurinol?

Answer 36

1) Febuxostat

Question 37

MOA of probenecid

Answer 37

Inhibits the reabsorption of uric acid in the proximal convoluted tubule

Question 38

MOA of colchicine

Answer 38

Binds and stabilizes tubulin to inhibit polymerization, impairing leukocyte chemotaxis and degranulation