WEEK 7 rheumatoid

Question 1

MOA of adalimumab, certolizumab, infliximab, golimumab

Answer 1

monoclonal antibody to TNF- alpha

Question 2

adverse effects of anti- TNF inhibitors: adalimumab, certolizumab, infliximab, golimumab

Answer 2

demyleniating disease, CHF, drug induced lupus, TB, HEP B reactivation.

Question 3

indications for adalimumab, certolizumab, infliximab, golimumab

Answer 3

Rheumatoid arthritis, Psoriasis, Ankylosing spondylitis, IBD.

Question 4

MOA of Etanercept (Enbrel)

Answer 4

Fusion protein binds to patient’s TNF and blocks its interaction with cell surface receptors- TNF blocking agent

Question 5

adverse effects of Etanercept

Answer 5

demyleniating disease, CHF, drug induced lupus, TB, HEP B reactivation.

Question 6

Clinical indications of Entanercept

Answer 6

Rheumatoid Arthritis, Psoriasis, Ankylosing Spondylosis

Question 7

Hydroxychloroquine has a possible MOA of working on toll like receptors in order to help eleviate symptoms of what diseases?

Answer 7

Lupus, Sjorgrens

Question 8

Adverse Effects of Hydroxychloroquine?

Answer 8

Common: GI, Rash
Severe: Retinal toxicity, Prolonged QT

Question 9

MOA of methotextrate

Answer 9

Folic acid analog that competitively inhibits dihydrofolate reductase- decreasing dTMP- decreasing DNA synthesis.

Question 10

indications for methotrexate?

Answer 10

Rheumatoid arthritis, psoriasis, psoriatic arthritis, abortion- ecoptic pregnancy

Question 11

adverse effects Methotextrate

Answer 11

Hepatotoxicity, pulmunary fibrosis, mucositis, alopecia

Question 12

mOA of slufasalazine
Indication

Answer 12

not full understood- maybe inhibits nuertrophil migration

Indication: rheumatoid arthritis

Question 13

Mycophenolate- MOA
indication

Answer 13

Inhibits B and T cell proliferation

Indication: lupus, scleroderma, myositis especailly in patients that have associated interstitial lung disease

Question 14

Adverse effects of Mycophenolate

Answer 14

bone marrow suppression

Question 15

moa of cyclophosphamide

adverse effects

clinical use

Answer 15

alkylating agent- crosslinks dna inhibiting cell division.

bone marrow supression, decrease of lymphocytes, hemorragic cycstitis, bladdar cancer

lupus, scleroderma, myositis, vasculitits

Question 16

MOA- leflunomide
Adverse effects
Indications

Answer 16

inhibits pyrimidine synthesis for anti inflammatroy and anti proliferative effects
bone marrow suppression
rheumatoid arthritis

Question 17

Cyclosporine-
MOA
Indications

Answer 17

binds cyclophilin inhibits calcineurin which is important for T cell activation.

Psoriasis, Rheumatoid arthritis, Lupus, Transplant

Crutches: Immunosuppressant drugs = cyclosporine, tacrolimus, sirolimus, basiliximab 2. Blocking bull with 2 T-shaped horns: Calcineurin inhibitors (cyclosporine and tacrolimus) block T-cell activation by inhibiting IL-2 transcription 3. Lasso cyclone: Cyclosporine (calcineurin inhibitor) blocks T-cell activation by inhibiting transcription and synthesis of IL-2; binds to cyclophilin 4. Tack shield: Tacrolimus (calcineurin inhibitor) blocks T-cell activation by inhibiting transcription and synthesis of IL-2; binds to FK506 binding protein (FKBP) 5. Board supporting transplanted tree: Indications of cyclosporine and tacrolimus = transplant rejection prophylaxis 6. Silvery scale elbow patches: Indications of cyclosporine = psoriasis 7. Red gloves: Indications of cyclosporine: rheumatoid arthritis 8. Cracked kidney-shaped saddle: Adverse side effects of cyclosporine and tacrolimus = nephrotoxicity 9. Cracked brain helmet: Adverse side effects of cyclosporine and tacrolimus = neurotoxicity 10. Blowing steam: Adverse side effects of cyclosporine and tacrolimus = hypertension