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34 Cards in this Set

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MOA Gold compounds
Prevent further damage by suppressing macrophages (depress their lysosomal enzyme activity)
Use of Gold compounds
Rapidly progressive RA or if un-responsive to other tx
Gold is contraindicated in
Hepatic disease
Kidney disease
Pregnancy
SE Gold
Dermatitis of skin & mucus membranes
Nephritis
Proteinuria
Agranulocytosis
chrysiasis (grey-blue skin)
Aplastic anemia
Gold OD txed w/
Dimercaprol
Effects of D-penicillamine
Reduce RF
Chelate heavy metals
SE D-penicillamine
SEVERE
Dermatitis to nephritis to aplastic anemia

(only used for heavy metal poisoning)
MOA Methotrexate
Inhibits DHFR
Methotrexate used to tx
LD - RA
HD - CA
SE Methotrexate
Cytopenia
Mucosal ulceration
N
Liver cirrhosis (rare)
Acute pneumonia-like syndrome (rare)
MOA Thalidomide
Inhibits production and secretion of TNF

***Very teratogenic***
Use Thalidomide
Leprosy
HIV-ass. skin lesion
MM
MOA Pentoxyfilline
Phosphodiesterase inhibitor (decreases TNF secretion)
Platelet aggregate inhibitor
Use Pentoxyfilline
Acute alcoholic hepatitis
MOA Infliximab
monoclonal Ab to TNF

(given IV)
Use Infliximab
RA
Ankylosing spondylitis
Psoriatic arthritis
Mod-severe active UC and Crohn's disease
SE Infliximab
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
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
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
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
Pregnancy

Caution - hepatic and CV disease
MOA Allopurinol
Inhibits Xanthine oxidase --> inhibiting uric acid production
Chronic gout treated with
Probenecid
MOA Probenecid
Blocks tubular reabsorption of uric acid
(only at high doses)
Pts that you seen chronic gout in
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
Drug that you never use in GOUT
ASA

Competes w/ uric acid at the renal transporters in PCT