RA

Question 1

What symptom makes RA different from OA?

Answer 1

Prolonged morning stiffness

Question 2

Have pt on DMARD within how long of RA diagnosis?

Answer 2

3 months

Question 3

What are the non biologic DMARDs used in RA?

Answer 3

Methotrexate 
Hydroxychloroquine 
Leflunomide
Sulfasalazine
Minocycline

Question 4

Methotrexate is used how?

Answer 4

Alone or in combo

Question 5

What doses of ibuprofen give anti-inflammatory affect?

Answer 5

Higher doses

Question 6

What agents are used short term in bridge therapy in RA?

Answer 6

NSAIDS and CS

Question 7

What type of dosing helps decrease adrenal suppression and toxic effects of steroids?

Answer 7

Alternate day therapy (ADT)

Question 8

What are the 2 name brands for methotrexate?

Answer 8

Rheumatrex

Trexall

Question 9

What kind of doses of methotrexate are used in RA?

Answer 9

Low weekly doses, never daily for RA

Question 10

Methotrexate can cause what toxicity?

Answer 10

Hepatotoxicity

Question 11

What two populations are CI in methotrexate therapy?

Answer 11

Pregnancy - category x

Alcoholism - alcohol and mtx combo increases hepatotoxicity

Question 12

Give what with mtx to decrease side effects?

Answer 12

Folic acid

Question 13

Give folic acid when during mtx treatment?

Answer 13

The day following mtx administration

Question 14

Sulfasalazine should be taken with what to prevent crystalluria?

Answer 14

Food and 8 oz of water

Question 15

What are 2 name brands of sulfasalazine?

Answer 15

Azulfidine

Sulfazine

Question 16

Sulfasalazine can cause what deficiency?

Answer 16

Folate

Question 17

RA manifestations are always what?

Answer 17

Polyarticular and symmetrical

Question 18

Sulfasalazine causes what coloration of skin/urine?

Answer 18

Yellow orange

Question 19

Sulfasalazine impairs absorption of what?

Answer 19

Folate

Supplement with 1mg of folic acid

Question 20

What are minocycline’s 2 name brands?

Answer 20

Minocin

Solodyn

Question 21

What instructions are needed for Minocycline administration?

Answer 21

Drink with 8 oz of water

Stay upright for 30 minutes after taking

Question 22

Don’t give tetracycline antibiotics to what two groups of people?

Answer 22

Pregnancy

Children 8 or under

Question 23

Tetracyclines cause what sensitivity?

Answer 23

Photosenitivity

Question 24

What is leflunomide’s name brand?

Answer 24

Arava

Question 25

Who should absolutely not get leflunomide?

Answer 25

Pregnant women | Category X

Question 26

Must wait how long after discontinuing leflunomide to get pregnant?

Answer 26

2 years after

Question 27

Leflunomide can cause what toxicity?

Answer 27

Hepatotoxicity

Question 28

What DMARDs can you take with methotrexate?

Answer 28

Leflunomide | Tofacitinib

Question 29

What if Tofacitinib name brand?

Answer 29

Xeljanz

Question 30

Don't use Xeljanz with what other RA agents?

Answer 30

Biologic DMARDs

Question 31

Don't take methotrexate with what because increase risk of hepatotoxicity?

Answer 31

Alcohol

Question 32

Methotrexate decreases the effectiveness of what diuretics?

Answer 32

Loops

Question 33

Loop diuretics to what to methotrexate?

Answer 33

Increase methotrexate concentrations

Question 34

Methotrexate when used concomitantly with what med cause an increase in both med concentrations?

Answer 34

Cyclosporine

Question 35

Methotrexate is what pregnancy category?

Answer 35

X

Question 36

What main class of biologic DMARDs are used in RA?

Answer 36

TNF inhibitors

Question 37

What is etanercept name brand?

Answer 37

Enbrel

Question 38

What is Humira generic?

Answer 38

Adalimumab

Question 39

What is Remicades generic?

Answer 39

Infliximab

Question 40

What is certolizumab name brand?

Answer 40

Cimzia

Question 41

What is Simponi generic?

Answer 41

Golimumab

Question 42

What TNF inhibitors are used only in combo with methotrexate for RA?

Answer 42

Remicade | Simponi

Question 43

What should be tested for before starting biologics?

Answer 43

TB test

Question 44

All TNF inhibitors must be stored how?

Answer 44

In refrigerator

Question 45

Allow each TNF inhibitors to do what before administration?

Answer 45

Come to room temp over 15-30 minutes

Question 46

Don't use biologics how?

Answer 46

More than one concurrently

Question 47

What 4 bad things can happen with TNF inhibitor therapy?

Answer 47

HBV reactivation Heart failure Hepatotoxicity Lupus like syndrome

Question 48

What is rituximabs name brand?

Answer 48

Rituxan

Question 49

How does rituximab work?

Answer 49

Deleted CD20 B cells

Question 50

Is Rituxan given with or without methotrexate in RA?

Answer 50

With

Question 51

Screen for what two things before Rituxan initiation?

Answer 51

TB | HBV

Question 52

Anakinra has what mechanism of action?

Answer 52

IL-1 receptor antagonist

Question 53

What is Anakinra's name brand?

Answer 53

Kineret

Question 54

What MOA does abatacept have?

Answer 54

Inhibits T cell activation by binding to CD80 and CD86

Question 55

What is abatacept name brand?

Answer 55

Orencia

Question 56

Caution abatacept use with what co morbidity?

Answer 56

COPD | may worsen symptoms

Question 57

MOA of tocilizumab?

Answer 57

IL-6 receptor antagonist

Question 58

What is tocilizumab's name brand?

Answer 58

Actemra

Question 59

Where should biologics be administered?

Answer 59

Upper middle thigh | Abdomen

Question 60

What vaccine can patients in biologics still get?

Answer 60

Influenza

Question 61

Get Simponi to room temperature how?

Answer 61

Letting product sit at room temp for 30 minutes