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Flashcards in Nonbiologic DMARD Deck (43):
1

Sulfasalazine Class

non-biologic DMARD

2

Sulfasalazine MOA

systemic: inhibits PG, decrease IgA, IgM
local: colon reduces inflammatory response

3

Sulfasalazine Indication

1. RA
2. ulcerative colitis
3. Crohns Disease

4

Sulfasalazine SE

1. reversible oligospermia
2. jaundice
3. photosensitivity

5

Sulfasalazine Contra

1. GI/GU obstruction
2. G6PD Deficiency
3. folate deficiency

6

Sulfasalazine dx-dx

1. increase oral hypoglycemics
2. NSAIDs increase impact

7

Sulfasalazine Other

1. only 10-20% oral dose absorbed
2. reversible infertility in men

8

Tofacitinib Class

Nonbiologic DMARDs, JAK inhibitor

9

Tofacitinib MOA

Inhibits JAK enzymes, decrease IgG, IgM, IgA

10

Tofacitinib Indications

RA in adults not responding to methotrexate

11

Tofacitinib SE

1. infection (20%)
2. HTN
3. HA
4. GI perforation
5. hepatotoxicity
6. TB
7. lipid abnormalities

12

Tofacitinib Contra

1. hepatitis!
2. TB
3. egfr

13

Tofacitinib dx-dx

1. MAJOR CYP3A4 substrate!!
2. concurrent BDMARDs

14

Tofacitnib other

1. BLACK BOX WARNING: TB, infection
2. monotherapy or NBDMARD

15

Hydroxychloroquine Class

Nonbiologic DMARD

16

Hydroxychloroquine MOA

suppression of T cells

17

Hydroxychloroquine Indications

1. RA
2. SLE
3. Malaria

18

Hydroxychloroquine SE

1. abd pain
2. nightmares
3. ocular toxicity (need eye exams q6 months)
4. myopathy

19

Hydroxychloroquine Contra

1. psoriasis
2. G6PD def

20

Hydroxychloroquine Other

1. avoid ethanol
2. extensive in melanin tissues (eyes)
3. t1/2 45 days

21

Methotrexate Class

Nonbiologic DMARD

22

Methotrexate MOA

Inhibits dihydrofolate, inhibits cytokines

23

Methotrexate PG

X!

24

Methotrexate Indications

recent RA (

25

Methotrexate SE

1. pulmonary fibrosis
2. hepatotoxicity
3. Stevens-Johnson
4. subacute toxicity

26

Methotrexate Contra

1. renal/liver disease
2. bone marrow disease
3, AIDs

27

Methotrexate dx-dx

1. live vaccines
2. warfarin
3. ethanol

28

Methotrexate other

Initial response: 3-4 weeks
full response: 3-6 months

folic acid w/treatment

29

Cellcept Class

semisynthetic DMARD

30

Cellcept MOA

immunosuppression of T and B lymphocytes

31

Cellcept PG

D

32

Cellcept Indications

1. RA
2. post organ transplant

33

Cellcept SE

1. decrease CBC
2. hyper/hypotension
3. chest pain
4. tachycardia
5. insomnia
6. elevated BS

34

Cellcept Contra

Infections

35

Cellcept Monitor

glucose!

36

Cyclophosphamide Class

Anti-neoplastic Alkylating Agent

37

Cyclophosphamide MOA

prevents cell division by cross-linking DNA, decreasing DNA synthesis, cell phase nonspecific

38

Cyclophosphamide PG

D

39

Cyclophosphamide Indications

1. RA
2. Cancers (leukemia, breast, lymphoma, myeloma)
3. corticoid refractory nephrotic syndrome

40

Cyclophosphamide SE

1. cardiotoxicity
2. decreased fertility
3. hepatic/pulm toxicity
4. hyponatermia

41

Cyclophosphamide Contra

1. urinary tract outflow obstruction
2. myelosuppression

42

Cyclophosphamide dx-dx

1. clozepine
2. echinacea
3. tofacitinib
4. vaccines

43

Cyclophosphamide other

prodrug, requires hepatic activation