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Pharm Flashcards

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1
Q

what is the mainstay of therapy for many chronic inflammatory and autoimmune diseases

A
  • glucocorticoids
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2
Q

the mechanism of action of glucocorticoids is via regulation of _______

A
  • transcription
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3
Q

what cellular processes do glucocorticoids suppress

A
  • macrophage activation
  • cellular immunity
  • cytokine production
  • WBC trafficking
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4
Q

some side effects of glucocorticoids

A
  • CNS effects
  • fluid retention/weight gain/Cushings
  • hyperglycemia
  • HTN
  • infection
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5
Q

things to do before starting patients on glucocorticoids

A
  • PPD test
  • check vaccination
  • measure bone density to reduce risk for osteoporosis
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6
Q

what anti malarial drug is used for autoimmune disease

A
  • hydroxychloroquine
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7
Q

MOA of hydroxychloroquine

A
  • inhibit TLR signaling

- decrease cytokines, lymphocytes, NK activity

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8
Q

what conditions do we use hydroxychloroquine in

A
  • SLE
  • RA
  • Sjogren
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9
Q

contraindications of hydroxychloroquine

A
  • retinopathy

- G6PD deficiency

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10
Q

adverse events of hydroxychloroquine

A
  • retinal toxicity

- myopathy/cardiomyopathy

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11
Q

screening for hydroxychloroquine

A
  • ophthalmology screening
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12
Q

MOA of methotrexate

A
  • inhibits DHFR
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13
Q

what conditions do we use methotrexate with

A
  • rheumatic diseases

- inflammatory diseases

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14
Q

what is the drug of choice with rheumatoid arthritis

A
  • methotrexate
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15
Q

what must you give with MTX to avoid oral ulcers and other side effects

A
  • folic acid
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16
Q

side effects of MTX

A
  • mucosal ulceration
  • hepatotoxicity
  • bone marrow toxicity
  • pneumonitis
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17
Q

what is important to monitor in patients taking MTX

A
  • liver function tests
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18
Q

can you use methotrexate in pregnancy

A
  • no
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19
Q

drug interactions with MTX

A
  • sulfamethoxazole
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20
Q

MOA of leflunomide

Study These Flashcards
A
  • inhibits dihydroorate dehyrogenase
  • reduces pyrimidine synthesis
  • reduces activated T cells
21
Q

for what conditions do you use leflunomide

Study These Flashcards
A
  • inflam arthritis

- SLE

22
Q

can you use lefluonimide in pregnancy

23
Q

side effects of lefluonimide

Study These Flashcards
A
  • rash
  • alopecia
  • diarrhea
24
Q

toxicities of lefluonimide

Study These Flashcards
A
  • liver tox

- bone marrow tox

25
what do you give in case of toxicity or pregnancy on lefluonimide
- chlestyramine
26
what conditions do you give Azathioprine to treat
- SLE - systemic vasculitis - inflammatory myopathy
27
toxicities of azathioprine
- infection - bone marrow - hepatotoxicity - malignancy
28
what do you measure to check bone marrow toxicity in patients on azathioprine
- thiopurine methyltransferase
29
drug interactions with Azathioprine
- allopurinol - sulfasalazine - trimethoprim - ACE-inhibitors
30
can you use azathioprine in pregnancy
- yes!
31
you can use mycophenolate in these conditions
- SLE - scleroderma lung disease - inflammatory myopathy - vasculitis
32
side effects of mycophenolate
- dyspepsia - diarrhea - rash
33
adverse effects of mycophenolate
- CMV infections - bone marrow suppression - malignancy
34
MOA of cyclophosphamide
- alkylating agent
35
conditions cyclophosphamide treats
- SLE - vasculitis - scleroderma
36
what do you give with cyclophosphamide to protect the bladder from dyspepsia what is the bad breakdown product
- MESNA | - acrolein
37
toxicities of cyclophosphamide
- infection risk - hemorrhagic cystitis - infertility - bone marrow suppression
38
what conditions do we use TNF alpha inhibitors in
- rheumatoid arthritis - psoriatic arthritis - juvenile arthritis
39
do we use TNF alpha inhibitors in lupus why?
- no | - worsen disease
40
adverse effects of TNF alpha inhibitors
- reactivation of extrapulmonary TB or Hep B
41
do we give live vaccines with monoclonal antibodies
- NO
42
MOA of rituximab
- against CD20 | - depletes B cells
43
what conditions do we use rituximab for?
- rheumatoid arthritis - ANCA - SLE
44
adverse effects of rituximab
- serum sickness - reactivation of Hep B - progressive multifocal leukoencephalopathy
45
MOA of Tocilizumab
- blocks IL-6 signaling
46
what conditions do we use tocilizumab to treat?
- RA - juvenile arthritis - giant cell arthritis
47
MAO of Belinumab
- blocks activation of Blys/BAFF | - Blys/BAGG binds to autoreactive B cells and helps them to produce autoantibodies.
48
what do we use Belinumab to treat
- refractive SLE
49
what do we use IVIg to treat
- Kawasaki dz - ITP - SLE - inflammatory myopathy

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