RA Pharmacotherapy

Question 1

What does PQRSTA stand for?

Answer 1

P - precipitating
Q - quality
R - region/radiating
S - severe
T - temporal
A - any associated Sx

Question 2

What allergy is important for RA management?

Answer 2

sulfa

Question 3

3 disease severity scales most common in US

Answer 3

CDAI
PAS
DAS

Question 4

A ACR/EULAR score of ___ or higher is classified as definite RA

Answer 4

6

Question 5

Early RA is < __ months

Answer 5

6

established RA is >= 6 months

Question 6

Failure of __ or more synthetic DMARDS is poor RA prognosis

Answer 6

2

Question 7

What is main goal of RA therapy?

Answer 7

complete disease remission or low disease activity

“treat to target”

Question 8

__ is joint reconstruction or replacement

Answer 8

arthroplasty

Question 9

__ is joint examination with possible removal of bone fragments or cartilage

Answer 9

arthroscopy

Question 10

__ is bone or joint fusion

Answer 10

arthrodesis

Question 11

Which drug class needs DEXA and FRAX assessment at regular monitoring interval?

Answer 11

corticosteroids

Question 12

Which class can cause TB?

Answer 12

TNF alpha inhibitors

Question 13

Abatacept dose for pt < 60kg?

Answer 13

500mg

Question 14

Abatacept dose for pt 60-100kg

Answer 14

750mg

Question 15

abatacept dose for pt > 100kg

Answer 15

1000mg every 2 weeks for 2 doses after the initial dose

Question 16

Abatacept should not be given with what other drug class?

Answer 16

TNF alpha inhibitors

Question 17

Premedicate with what 3 things with rituximab?

Answer 17

diphenhydramine
glucocorticoid
acetaminophen

Question 18

DMARD monotherapy should be started within __ months of RA diagnosis

Answer 18

3

Question 19

What is preferred DMARD for early RA?

Answer 19

MTX

Question 20

What is preferred for combo therapies for mod to high RA?

Answer 20

synthetic DMARDs

Question 21

Monotherapy is ineffective for mod to high RA

a. true
b. false

Answer 21

a true

Question 22

Which is more effective for early RA?

DMARD (MTX) + biologic or biologic monotherapy?

Answer 22

DMARD (MTX) + biologic

Question 23

Can JAKi be used for early RA?

Answer 23

no

Question 24

Can all therapies be d/c for established RA?

Answer 24

no

Question 25

Avoid which RA drug class in HF pts?

Answer 25

TNF alpha inhibitors

Question 26

3 main high risk conditions for RA therapy?

Answer 26

CHF Hep B/C malignancies

Question 27

Which is preferred for pts with Hep C DMARDs or TNF alpha inhibitors?

Answer 27

DMARDs

Question 28

When should live vaccines be given to RA pts?

Answer 28

BEFORE DMARD therapy!! killed vaccines (pneumococcal, IM influenza, hep B) and recombinant (HPV) can be given during therapy

Question 29

Two main leflunomide AEs?

Answer 29

hepatitis, jaundice