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52 Cards in this Set
- Front
- Back
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primary endogenous glucocorticoids? |
Cortisol |
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primary endogenous mineralcorticoids? |
aldosterone |
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what is Addison's disease? |
- also called adrenal insufficiency (the amount steroids produced is too little and need to be replaced) - txm: fludrocortisone is used to replace aldosterone |
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Steroids use to do what? |
- it is potent inhibitor of inflammatory processes - steroids will reduce inflammatory |
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what is Cushing syndrome? |
- due to excess endogenous cortisol |
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long term SE of systemic steroids? |
- central redistribution of fat - moon facies - buffalo hump - impaired wound healing - dermal thining/bruise - psychiatric disturbances - Na / water retention - hyper K - hyper glycemic / DM - increase appetite / wt gain - immunosuppression - glaucoma/cataracts - growth retardation - amenorrhea - Hirsutism (in Women) - Acnes - insomnia/nervous - GI bleeding/ulcer |
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what is short term SE for steroids? |
- short term means using < 1 month - increase appetite, wt gain - fluid retention - emotional instability - insomnia - indigestion - bitter taste - increase BP, BG |
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cortisone is prodrug for what? |
cortisol |
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Prednisone is prodrug for what? |
prednisolone (use mostly in children) |
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What is RA clinical presentation? |
- chronic, symmetrical, systemic - inflammation of joints - stiffness, pain and eventually bone deformity - finger joints of hands are mostly affected (extraarticular) - morning stiffness is the clue - (OA does not cause prolonged stiffness) |
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what is RA diagnosis? |
signs & symptoms must present >= 6 weeks 4 or more criteria must be present |
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what is RA treatment? |
- should start with DMARD mono therapy - treatment target goal is remission - MTX (methotrexate) is prefer initially - NEVER use two biologics in combination |
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how to dose for MTX? |
- low weekly doses are used for RA - 2.5 mg Q12h x3 doses as course of once weekly - NEVER dose daily for MTX - Take weekly |
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what is SE for MTX? |
- nod, increase LFT, stomatitis, alopecia, photosensitivity - preg X - can give folate after MTX |
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SE for hydroxychloroquine (Plaquenil)??? |
- nod, abdominal pain, rash, pruritus, - HA, vision change, pigmentation change |
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SE for Sulfasalazine? |
- CI: sulfa and salicylate allergy - caution: G6PD deficiency - HA, rash, anorexia, nod, oliospermia, folate deficiency - NOTE: yellow-orange skin/urine - impairs folate absorption |
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what is brand for leflunomide? |
Arava - must have neg pregnancy test and use 2 forms of birth control |
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what is brand for Tofacitinib? |
Xeljanz - do NOT use with biologic DMARD - inhibit JAK enzymes |
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MTX counseling points? |
- should NOT taken with alcohol - for RA, take once a week, (NOT daily) - pregnant cat. X - NO breast feeding |
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brand names for MTX? |
- Otrexup (yellow color) - Rasuvo (yellow-brown color) - Rheumatrex - Trexall |
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Biologics (TNF alpha inhibitor) to treat RA? |
- entanercept (Enbrel) - adalimumab (Humira) - golimumab (Simponi) also: infliximab (Remide) , certolizumab (Cimzia) |
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Non TNF to treat RA? |
rituximab (Rituxan) - depletes CD20 B cells - HBV reactivation (screen for TB) |
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brand name of anakinra? and what is it? |
anakinra (Kineret) - it is IL-1 receptor antagonist - screen for TB |
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brand for abatacept? |
abatacept (Orencia) |
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brand for tocilizumab? |
tocilizumab (Actemra) |
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counseling points for adalimumab, etanercept, golimumab? |
- should not get live vaccines - lower ability to fight infections - test for TB - liver damages - store in fridge, (Enbrel, Humira can store in RT for 14 days) - do NOT shake - for Enbrel: foaming is normal |
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clinical presentation for Lupus? (SLE) |
- fatigue, depression, anorexia, wt loss, myalgia, malar rash (butterfly rash) - renal, hematologic, neurologic manifestations - lupus nephritis develops in over 50% of lupus patients |
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drugs treat Lupus? |
- hydroxychloroquine* (Plaquenil) - chloroquine (Aralen) - prednisone* or methylprednisolone* - mycophenolate* (CellCept)* - belimumab***(Benlysta)*** |
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sx of MS? |
- MS: pt's immune attacks the myelin sheath - early sx: fatigue, weakness, tingling, numbness, blurred vision |
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what are interferon beta formulations to treat MS? |
- Betaseron - Avonex - Rebif - Extavia - Plegridy |
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what are glatiramer acetate to treat MS? |
- Copaxone - Glatopa |
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what are oral meds to treat MS? |
- fingolimod (Gilenya) - teriflunomide (Aubagio) - dimethyl fumarate (Tecfidera) |
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most recent SC drug Q14 days to treat MS? |
- pegylated interferon beta (Plegridy) |
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How is glatiramer (Copaxone, Glatopa) is given? |
- 20 mg SC daily or: - 40 mg SC 3x a week (48hrs apart) |
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how is interferon beta 1a (Avonex, Rebif) is given? |
- Avonex: IM weekly - Rebif: SC 3x per week |
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how is interferon beta 1b (Betaseron, Extavia, Betaconnect) is given? |
SC every other day |
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how is interferon beta 1a (Plegridy) is given? |
SC every 14 days |
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counseling for fingolimod (Gilenya)? |
- patient must be monitored for at least 6 hours after the first dose - Bradycardia (must monitor) - Macular edema - SE: HA, diarrhea, flu-like, back-pain, LFT - monitor: CBC, ECG, eye exam |
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counseling for dimethyl fumarate (Tecfidera)? |
DO NOT crush, chew or sprinkle capsule contents on food |
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what about natalizumab for MS? |
- brand is Tysabri - IV given over 1 hr every 4 weeks - SE: infusion related reaction, HA, fatigue |
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what need to know for alemtuzumab (Lemtrada) for MS? |
- 1st course: IV (over 4hrs) daily x5 days - 2nd course: IV daily x3 days (12 months after first course) - Total duration of therapy is 24 months NOTE: complete all vaccines 6 weeks before therapy, start antiviral prophylaxis on first day of each course and continue for 12 months or until CD4 count >= 200 |
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Raynaud's phenomenon? |
- drugs used for treatment are common and are used for several other conditions - triggered by exposed to cold/stress -- fingers and or toes, skin turn white then blue - Nifedipine is commonly used for prevention |
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what is Sjogrne's syndrome? |
- severe dry eyes and dry mouth |
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brand for cyclosporine? |
Restasis |
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what steroid have greatest anti-inflammatory? |
Betamethasone |
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generic for Orencia? |
abatacept |
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generic for Simponi |
golimumab |
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generic for Benlysta? |
belimumab |
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generic for: Simulect Regranex Treanda Survanta |
Simulect (basiliximab) Regranex (becaplermin) Treanda (bendamustine) Survanta (beractant) |
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SE of Copaxone? |
- Copaxone (glatiramer) -SE: inj site rxn, infection, pain, flushing, diaphoresis, dyspnea |
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conversion from dexamethasone to prednisone? |
0.75mg dexamethasone = 5mg prednisone |
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x |
x |
