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29 Cards in this Set
- Front
- Back
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Who do you give De penicillamine to? (patient population)
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rheumatoid arthritic patients, reduces rheumatoid factor. **chelates heavy metals and treats heavy metal poisioning (more common)
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What is the MOA of methotrexate?
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folic acid antagonist, inhibits DHFR
(treats rheumatoid arthritis, low doses and cancer at high doses) |
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What are the side effects of methotrexate?
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cytopenia, esp leukopenia and megaloblastic anemia, mucousal ulceration, nausea
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What are the anti-TNF agents?
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thalidomide, pentoxyfillin, infliximab, and etancercept
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What are the anti-inflamm drugs?
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NSAIDS, steroids, methotrexate, anti-TNF (extreme inflammation)
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What is the MOA of thalidomide?
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inhibits the production and secretion of TNF
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Who do you give thalidomide to?
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patients--leprosy, HIV associated skin lesions, multiple myeloma
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What is the MOA of pentoxyfilline?
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phosphodiesterase inhibitor, causes TNF secretion inhibition
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What does pentoxyfilline treat?
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acute alcoholic hepatitis
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What is the MOA of infliximab?
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monoclonal antibody against TNF
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What does infliximab treat?
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rheumatoid arthritis, ankylosing spondylitis, psoriatric arthritis, moderate-->severe ulcerative colitis, crohns dz
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What is the MOA of etancercept?
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recombinant TNF receptor, binds to TNF in the bloodstream
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What are the side effects of infliximab, etanercept, and adalimumab?
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increased chances of MS, optic neuritis, and myelitis
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What are the side effects of infliximab and etancercept?
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increased chances of MS, optic neuritis, and myelitis
TB life threatening sepsis (acute onset) secondary cancer serum sickness (antibodies against injected protein) others: headache, dyspnea, abdominal pain |
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What are the side effects of adalimumab?
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increased chances of MS, optic neuritis, and myelitis
aplastic anemia worsen heart failure |
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What is the MOA of adalimumab?
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monoclonal antibody against TNF (mouse human chimera)
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What do steroids inhibit?
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phospholipase A2
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What can cause chronic gout?
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kidney dz or malignancy
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What is the DOC for acute attacks of gout and its MOA?
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colchicine, binds to tubilin, mitotic inhibitor (like vincristine)
*decreases number of future attacks |
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What do you normally give for acute attacks of gout?
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NSAIDS (not aspirin)
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What patient population is colchicine contraindicated in?
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preggers, hepatic and CV dz
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What is the MOA of allopurinol?
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inhibits xanthine oxidase
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What syndrome is due to deficient HGPRT (essential for purine salvage)?
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Lesch-Nyhan syndrome, x linked recessive
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What are the S/S of Lesch-Nyhan syndrome?
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hyperuricemia, mental retardation, compulsive biting of lips and fingers, self mutilating activities.
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What happens to the EXCESS uric acid and how is it related to gout?
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uric acid-->phagocytosed by neutrophils-->leukotrienes + other mediators of inflammation. Lysosomes are ruptured-->phagocyte dies-->hydrolytic enzymes (phagocytosed urate released from dying cells)
*inflamm cells try to get rid of EXCESS uric acid but can't break down-->acute inflammation (attack) |
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What is the DOC for chronic gout?
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probenecid, blocks tubular reabsorption of uric acid
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Is probenecid a p450 inhibitor or inducer?
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Probenecid is a p450 inducer
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Do we give low or high doses of probenecid?
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High doses because it will compete with uric acid at the renal transporters (therapeutic)
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Why do we avoid aspirin in gout patients?
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bc uses renal transporters like uric acid
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