Test 4 - Rheumatoid Arthritis Meds (Josh) Flashcards Preview

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Flashcards in Test 4 - Rheumatoid Arthritis Meds (Josh) Deck (24)
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1
Q

Rheumatoid Arthritis is an —– disease.

A

Autoimmune

2
Q

Pathophysiology of RA?

A

Inflammation causes synovial membrane to grow, replacing cartilage and eventually fusing the join together

3
Q

The hands of RA clients will have which noticeable feature?

A

Ulnar drift

Fingers will drift towards the Ulnar bone

4
Q

Three major groups of RA meds?

A
  • NSAIDS
  • Glucocorticoids
  • Disease-modifying Anti-rheumatic Drugs (DMARDs)
5
Q

Which class is rapid relief an which is slower?

A

NSAIDs (rapid)
Glucocorticoids (rapid)
DMARDs (slower)

6
Q

—- do NOT slow down the disease process.

A

NSAIDs

7
Q

—- DO slow down the disease process.

A

Glucocorticoids

  • but have lots of S/E so don’t want to stay on them long-term
8
Q

DMARDs we talked about?

A
  • Methotrexate
  • Hydroxychloroquine
  • TNF Blockers
9
Q

MOA: Methotrexate

A

Block DHFR enzyme that converts Folic Acid into DNA, thus taking away ability to make WBCs, thus decreasing # of cytokines

10
Q

S/E w/ Methotrexate:

A
  • Nausea/Diarrhea (biggest S/E)
  • GI ulceration
  • decrease bone marrow
  • Pneumonitis
  • Hepatotoxicity
  • Renal Failure
  • Infection
  • Severe Rash

Has 11 BBW!!!!

11
Q

S/E w/ Hydroxychloroquine

A
  • severe N/V/D if taken W/OUT Food

- Retinal Damage

12
Q

Take which med w/ food?

A

Hydroxychloroquine

13
Q

Watch for vision changes with which med?

A

Hydroxychloroquine

14
Q

MOA: TNF Blockers

A

Block TNF, on elf the major cytokines of the inflammatory process

15
Q

TNF Blockers we studied:

A
  • infliximab
  • adalimumab
  • etanercept

All are IV or subQ

16
Q

Common A/E of TNF Blockers?

A
  • injection site reactions

- infections

17
Q

Rare A/E of TNF Blockers?

A
  • Severe Allergic Reactions (Steven’s Johnson)
  • HF
  • Hepatotoxicity
  • Cancer
18
Q

—- are drugs of first choice in treating RA b/c of their rapid onset.

A

NSAIDs

19
Q

What periodic blood work is needed for a client taking Methotrexate?

A

Methotrexate Test

20
Q

How often should Methotrexate be taken?

A

Once a week

21
Q

Which S/E of Methotrexate is most likely to occur?

A

Nausea & Diarrhea

22
Q

Which exam should a client taking hydroxychloroquine take regularly?

A

Exe exam

  • due to the risk of retinal damage
  • report any VISION CHANGES
23
Q

Why check immunization status before beginning TNF-Inhibitors?

A

Increases risk of infections due to its immunosuppressant properties

24
Q

A client taking which drug should report exposure to a communicable disease?

A

TNF-Inhibitor

  • because of the risk for serious infections do to suppressed immune system by blocking TNF