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25 Cards in this Set
- Front
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diagnosis criteria for RA
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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 |
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NSAID used for rheumatoid arthritis
ibuprofen BBW |
CV
Coronary artery bypass graft GI |
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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 |
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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 |
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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 |
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DMARD-hydroxychloroquine
brand? SE Dosing |
Plaquenil
SE- decreased visual acuity, photophobia, blurred vision, corneal deposits, macular damage Take w/ food or milk |
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DMARD-sulfasalazine
CI Notes |
CI-sulfa allergy
Preg Cat B yellow-orange urine/skin |
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DMARD
leflunomide brand? BBW CI |
Arava
BBW- hepatotoxicity and women of child bearing potential CI-Pregnancy (Cat X) |
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Tofacitinib
brand BBW Notes |
xeljanz-inhibits janus kinase
BBW- cause serious infxn Notes- do NOT use with DMARDS or other immunosupp |
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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 |
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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 |
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etanercept
brand? dosing how oftern |
Enbrel
every week |
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adalimumab
brand? dosing |
Humira
every other week if with MTX, otherwise weekly |
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infliximab
brand dosing notes |
remicade
infusion rxn: premed with APAP + Benadryl can have 3-10 dqy delayed hypersens rxn |
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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) |
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NON-TNF Biologics
anakinra brand moa |
kineret
IL-1 receptor antagonis |
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NON-TNF Biologics
abatacept brand moa |
orencia
tcell costimulator, inhibits T-Cell activation |
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how should biologics be stored and how should they be administered
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all should be in fridge
administer in upper middle thigh or abdomen |
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meds known for causing LUPUS (SLE)
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hydralazine, isoniazid, chlorpromazine, quinidine, methyldopa, minocycline, and procainamide
|
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common clinical symptoms of SLE
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Rash over bridge of nose...butterfly rash
fever, weight loss, joint paint/stiffness |
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antimalarial agents used for lupus
which is safer |
hydroxychloroquine-safer
chloroquine |
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med used to control flashes of SLE
usually high doses |
prednisone 1mg/kg/day then taper
|
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cytotoxic agents for SLE
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cyclophosphamide
azathioprine mycophenolate |
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cyclophosphamide
how is it used |
for flares, not for chronic use, very toxic
|
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biologic for SLE
Belimumab brand |
benlysta
inhibits B lymphocyte activation |