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34 Cards in this Set
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- Back
MOA Gold compounds
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Prevent further damage by suppressing macrophages (depress their lysosomal enzyme activity)
|
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Use of Gold compounds
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Rapidly progressive RA or if un-responsive to other tx
|
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Gold is contraindicated in
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Hepatic disease
Kidney disease Pregnancy |
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SE Gold
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Dermatitis of skin & mucus membranes
Nephritis Proteinuria Agranulocytosis chrysiasis (grey-blue skin) Aplastic anemia |
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Gold OD txed w/
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Dimercaprol
|
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Effects of D-penicillamine
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Reduce RF
Chelate heavy metals |
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SE D-penicillamine
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SEVERE
Dermatitis to nephritis to aplastic anemia (only used for heavy metal poisoning) |
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MOA Methotrexate
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Inhibits DHFR
|
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Methotrexate used to tx
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LD - RA
HD - CA |
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SE Methotrexate
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Cytopenia
Mucosal ulceration N Liver cirrhosis (rare) Acute pneumonia-like syndrome (rare) |
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MOA Thalidomide
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Inhibits production and secretion of TNF
***Very teratogenic*** |
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Use Thalidomide
|
Leprosy
HIV-ass. skin lesion MM |
|
MOA Pentoxyfilline
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Phosphodiesterase inhibitor (decreases TNF secretion)
Platelet aggregate inhibitor |
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Use Pentoxyfilline
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Acute alcoholic hepatitis
|
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MOA Infliximab
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monoclonal Ab to TNF
(given IV) |
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Use Infliximab
|
RA
Ankylosing spondylitis Psoriatic arthritis Mod-severe active UC and Crohn's disease |
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SE Infliximab
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Increase risk of acute onset life-threatening sepsis, acquisition & spread TB, lymphoma and other CA
Higher incidence MS, myelitis, optic neuritis Serum sickness (HA, dyspnea, abd pain) |
|
MOA Etanercept
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recombinant TNF R
(given subQ) |
|
Use Etanercept
|
RA
Ankylosing spondylitis Psoriatic arthritis Juvenile RA |
|
SE Etanercept
|
Increased risk of Acute onset life-threatening sepsis, TB
Higher incidence for MS, myelitis, optic neuritis |
|
MOA Adalimumab
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fully humanized monoclonal Ab to TNF
|
|
Use adalimumab
|
RA
Psoriatic arthritis Ankylosing spondylitis Crohn's disease **Not approved for use in kids |
|
SE adalimumab
|
Aplastic anemia
Thrombocytopenia Leukopenia High incidence MS, optic neuritis, myelitis Worsen HF |
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Acute Gout attacks precipiated by
|
High alcohol consumption
High purine diet Kidney disease |
|
Chronic Gout due to
|
Kidney disease
Malignancy |
|
MOA Colchicine
|
Binds tubulin --> disrupts cell's ability to migrate
Stops mitosis Inhibits synthesis and release leukotrienes |
|
Use Colchicine
|
Acute gout attack
|
|
Colchicine contraindicated in
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Pregnancy
Caution - hepatic and CV disease |
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MOA Allopurinol
|
Inhibits Xanthine oxidase --> inhibiting uric acid production
|
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Chronic gout treated with
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Probenecid
|
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MOA Probenecid
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Blocks tubular reabsorption of uric acid
(only at high doses) |
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Pts that you seen chronic gout in
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High urate
Lesch Nyhan Syndrome Undergoing tx for malignancy |
|
What is Lesch Nyhan syndrome
|
XR
deficiency in HGPRT s/s - hyperuricemia, MR, compulsive biting lips and fingers, self-mutilating |
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Drug that you never use in GOUT
|
ASA
Competes w/ uric acid at the renal transporters in PCT |