Systemic Steroids & Autoimmune Conditions Flashcards Preview

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Flashcards in Systemic Steroids & Autoimmune Conditions Deck (63):
1

Celestone

betamethasone

2

DexPak

dexamethasone

3

Solu-Cortef

hydrocortisone

4

Medrol
Solu-Medrol
A-Methapred
Depo-Medrol

methylprednisolone

5

Deltasone
Prednisone Intensol
Rayos

prednisone

6

Millipred
Orapred ODT
Pediapred

prednisolone

7

Kenalog
Aristospan

triamcinolone

8

Symptoms of rheumatoid arthritis

joint swelling
pain
stiffness
bone deformity

9

Preferred initial therapy in rheumatoid arthritis

methotrexate

10

Trexall
Otrexup
Rasuvo
Rheumatrex

methotrexate

7.5-50mg once weekly

11

Methotrexate MOA

Irreversibly binds and inhibits dihydrofolate reductase, inhibiting folate, thymidylate synthetase and purine.
Has immune modulator and anti-inflammatory activity.

12

Plaquenil

hydroxychloroquine

400mg/day initially then 300mg/day for maintenance dose

*retinopathy
loss of visual acuity
pigmentation changes of the skin and hair (rare)

13

Azulfidine

sulfasalazine

500-1,000mg/day initially then BID for maintenance
MDD 3grams

Do not use with sulfa or salicylate allergy

Watch for G6PD deficiency.
HA,rash

impairs folate absorption
yellow-orange coloration of skin/urine

14

Arava

leflunomide

boxed warning: embryo-fetal toxicity

15

Xeljanz

tofacitinib

5mg BID

16

Xeljanz MOA

inhibits Janus kinase enzymes which stimulate immune cell function

17

MTX pregnancy category

X

18

Enbrel

etanercept
anti-TNF

50mg SC weekly

19

Humria

adalimumab
anti-TNF

50mg SC every other week
if no MTX can be 40mg SC weekly

20

Remicade

infliximab
anti-TNF

IV
requires filter and stable in NS only

21

Cimzia

certolizumab pegol
anti-TNF

22

Simponi

golimumab
anti-TNF

23

anti-TNF warnings

Can cause demyelinating disease
Hepatitis B reactivation
Heart failure, hepatotoxicity
Myelosuppression and severe infections
Do not use with other biological DMARDs or live vaccines.

24

Monitoring for anti-TNF biologics

TB test prior to initiation and annually if signs are present
Monitor for signs of infection

25

Rituxan

rituximab
depletes CD20 B cells

Pre-medicate with steroid, acetaminophen, and anthistamine.

26

Rituxan boxed warnings

Infusion-related reactions
Hepatitis B reactivation
Screen for HBV and HCV prior to initiating therapy

27

Kineret

anakinra
IL-1 receptor antagonist

daily SC administration

Warnings: malignancies and serious infections
Screen for TB

28

Orencia

abatacept
selective T cell costimulator
inhibits T cell activation

29

Actemra

tocilizumab
IL-6 receptor antagonist

30

Common symptoms of SLE

fatigue
depression
anorexia
weight loss
muscle pain
malar rash

31

Lupus nephritis develops in over ____% of patients with SLE

50

32

Time to see maximal effect of Plaquenil

6 months

33

Imuran, Azasan

azathioprine

2mg/kg daily

TPMT deficiency are at increased risk for myelosuppression

34

Cellcept

mycophenolate

SLE is off label use

35

Gengraf
Neoral

cyclosporine

36

Benlysta

belimumab

IgG1-lambda monoclonal antibody that prevents the survival of b lymphocytes

37

First line therapies in MS

interferon beta formulations and glatiramer acetate

38

MOA of glatiramer acetate

Immune modulator thought to induce and activate T-lymphocyte suppressor cells in relapsing form of MS.

Exact mechanism is not well dfeined.

39

Copaxone
Glatopa

glatiramer acetate

20mg SC daily or 40mg SC 3 times per week

40

Avonex
Rebif

interferone beta-1a

41

Betaseron
Betaconnect

interferon beta-1b

42

Plegridy

peginterferon beta-1a

43

Aubagio

teriflunomide

oral immune modulator
active metabolite of leflunomide

44

Gilenya

fingolimod

oral immune modulator

monitor patient for 6 hours after first dose

Warning for bradycardia, macular edema
Side effects: headache, diarrhea, flu-like symptoms, back pain, increased LFTs
Monitor: CBC, ECG, eye exam

45

Tecfidera

dimethyl fumarate

capsules
Do not crush/chew, or sprinkle capsule contents on food.

46

Ampyra

dalfampridine
potassium channel blocker may increase nerve signal conduction

Indicated to improve walking
Up to 6 weeks for efficacy; most patients do not respond

47

Tysabri

natalizumab
Monoclonal antibody that binds to alpha-4 subunit of integrins on leukocytes.

300mg IV given over 1 hour every 4 weeks.
Stable in NS only
REMS program available through TOUCH prescribing program.

Boxed warning for PML

48

Lemtrada

alemtuzumab

recombinant humanized monoclonal antibody

49

Zinbryta

daclizumab

recombinant monoclonal humanized antibody

Monitor LFTs monthly and up to 6 months after last dose.

50

Symptoms experienced in MS

incontinence - anticholinergics
constipation - laxatives
diarrhea - loperamide
muscle spasms - muscle relaxers
pain - pain meds
tremor - propranolol
depression - antidepressants
fatigue - modafinil, stimulants
dizziness/vertigo - meclizine, scopolamine

51

CCB for Raynaud's

nifedipine

52

Restasis

cyclosporine emulsion eye drops

Side effects: burning
Remove contact lenses prior to administration.
Separate by at least 15 minutes.

53

Xiidra

lifitegrast

Side effects: unusual taste

54

Salagen

pilocarpine
muscarinic agonist

55

Isopto Carpine
Pilopine HS

pilocarpine
muscarinic agonist

56

Evoxac

cevimeline
muscarinic agonist

57

Description of plaque psoriasis

raised, red patches covered with silvery white buildup of dead skin cells

58

Tazorac

tazorotene
topical retinoid

59

Soriatane

acetretin

60

Otezla

apremilast

61

Taltz

ixekizumab

62

Cosentyx

secukinumab

63

Stelara

ustekinumab