Rheumatoid Arthritis

Question 1

3 classes of tx for RA

Answer 1

1) NSAIDs
2) glucocorticoids
3) DMARDs

Question 2

1st DOC for RA

Answer 2

DMARD

Question 3

leflunomaide liver function concern

Answer 3

leflunomide + MTX = inc risk of hepatotoxicity

must monitor

Question 4

which drugs do not prevent disease progression or joint destruction in RA

Answer 4

NSAIDs and corticosteroids

Question 5

which drug reduces/prevents joint damage and can delay progression

Answer 5

DMARDs

Question 6

Biological vs nonbiological: MTX

Answer 6

non biological

Question 7

Biological vs nonbiological: leflunomide

Answer 7

non biological

Question 8

Biological vs nonbiological: hydroxychloroquine

Answer 8

non biological

Question 9

Biological vs nonbiological: sulfasalazine

Answer 9

non biological

Question 10

Biological vs nonbiological: cyclosporine

Answer 10

non biological

Question 11

Biological vs nonbiological: azathioprine

Answer 11

non biological

Question 12

Biological vs nonbiological: cyclophosphamide

Answer 12

non biological

Question 13

Biological vs nonbiological: adalimumab

Answer 13

biological - anti TNF

Question 14

Biological vs nonbiological: infliximab

Answer 14

biological - anti TNF

Question 15

Biological vs nonbiological: etanercept

Answer 15

biological - anti TNF

Question 16

Biological vs nonbiological: anakinra

Answer 16

biological

for mod to severe RA

Question 17

Biological vs nonbiological: rituximab

Answer 17

biological - usually given with MTX or another nonbiological DMARD

Question 18

Biological vs nonbiological: abatacept

Answer 18

biological

given to pt who didn’t respond to non-biologicals or anti-TNF

Question 19

cyclosporine AE

Answer 19

nephrotoxicity

Question 20

which drug tx refractory RA

Answer 20

azathioprine

Question 21

which drug is reserved for the most severe cases of rheumatoid

Answer 21

cyclophosphamide

Question 22

DOC for RA

Answer 22

MTX - mild, mod, or severe RA

Question 23

when are biological DMARDs appropriate

Answer 23

more moderate to severe RA

Question 24

if pt doesn’t respond to MTX, what next

Answer 24

try combo leflunomide + MTX

Question 25

least toxic of all DMARDs

Answer 25

hydroxychloroquine

Question 26

cyclophosphamide AE

Answer 26

long term use - inc risk of infection and malignancy

Question 27

anti-TNFalpha's (3)

Answer 27

adalimumab infliximab etanercept

Question 28

initial tx for RA

Answer 28

non-biological DMARD (MTX) + NSAID or corticoid if moderate: first line = TNF-inhibitors - biological DMARD + non-biological DMARD

Question 29

mildest RA cases tx

Answer 29

hydroxychloroquine | sulfasalazine

Question 30

first line DOC for RA in moderate to severe

Answer 30

TNF-inhibitors