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25 Cards in this Set

  • Front
  • Back
diagnosis criteria for RA
4 or more > or - 6 weeks

1 morning stiffness >1H
2 arthritis (swelling) in 3 or more joints
3 swelling of hands, feet or wrist
4 symmetric involvement
5 SC nodules
6 + serum rheumatoid factor
NSAID used for rheumatoid arthritis
ibuprofen BBW
CV
Coronary artery bypass graft
GI
COX2 inhib for RA
Celebrex
BBW and special stuff about it
BBW- same as ibuprofen

highest COX2 selectivity
lowest GI risk, but stil increased MI / stoke risk
Meds for RA
Prednisone
long term and short term SE
short term- <1 month: weight gain, emotional instab (euphoria, mood swings), fluid retention

long term- cushings/adrenal suppression, impaired would healing, acne, menstrual irreg, muscle wasting
osteoporosis
DMARDs- disease modifying anti-rheumatic drugs
methotrexate
MOA
Dosing
SE
folate antimetabolite inhibits DNA synthesis

low WEEKLY doses-can be broken up into 3/week, but never daily

SE- NVD, Gi upset, anorexia, reddening of skin
DMARD-hydroxychloroquine
brand?
SE
Dosing
Plaquenil

SE- decreased visual acuity, photophobia, blurred vision, corneal deposits, macular damage

Take w/ food or milk
DMARD-sulfasalazine
CI
Notes
CI-sulfa allergy

Preg Cat B
yellow-orange urine/skin
DMARD
leflunomide
brand?
BBW
CI
Arava
BBW- hepatotoxicity and women of child bearing potential

CI-Pregnancy (Cat X)
Tofacitinib
brand
BBW
Notes
xeljanz-inhibits janus kinase

BBW- cause serious infxn

Notes- do NOT use with DMARDS or other immunosupp
TNF inhibitors- Tumor necrosis factor
class BBW
Cass CI
Class SE
Monitoring
BBW-serious infxn
CI- sepsis
SE-infection and injection site reactions
monitor-wbc, signs of heart failure, LFTs, TB test
1st line med RA
add on therapy?

if initial presentation is severe can start...
MTX is 1st line and TNF inhib are addon

or if severe enough, initial tx

do NOT use biological (TNF) in combo or use with live vaccines
etanercept
brand?
dosing how oftern
Enbrel
every week
adalimumab
brand?
dosing
Humira

every other week if with MTX, otherwise weekly
infliximab
brand
dosing notes
remicade

infusion rxn: premed with APAP + Benadryl

can have 3-10 dqy delayed hypersens rxn
other biologics-NON-TNF biologics
rituximab
brand?
BBW
Monito
rituxan

BBW- fatal infusion rxn, can be on 1st infusion
PML (leukoencephalopathy)
SJS
monitor- CD20 B cells (depletes them)
NON-TNF Biologics
anakinra
brand
moa
kineret

IL-1 receptor antagonis
NON-TNF Biologics
abatacept
brand
moa
orencia

tcell costimulator, inhibits T-Cell activation
how should biologics be stored and how should they be administered
all should be in fridge

administer in upper middle thigh or abdomen
meds known for causing LUPUS (SLE)
hydralazine, isoniazid, chlorpromazine, quinidine, methyldopa, minocycline, and procainamide
common clinical symptoms of SLE
Rash over bridge of nose...butterfly rash
fever, weight loss, joint paint/stiffness
antimalarial agents used for lupus

which is safer
hydroxychloroquine-safer

chloroquine
med used to control flashes of SLE

usually high doses
prednisone 1mg/kg/day then taper
cytotoxic agents for SLE
cyclophosphamide
azathioprine
mycophenolate
cyclophosphamide
how is it used
for flares, not for chronic use, very toxic
biologic for SLE
Belimumab
brand
benlysta
inhibits B lymphocyte activation