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36 Cards in this Set
- Front
- Back
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what are DMARDS
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disease modifying agents of rheumatoid disease
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key factors of DMARDS
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1.) diverse group
2.) different benifits and problems 3.) combos improve efficacy 4.) considered if NSAIDS fail |
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Methotrexate
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treatment alone or in combo
used in RA & PA once weekly dosing response occurs in 3-6 weeks |
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What are the SE of Methotrexate?
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1.) mucosal ulcers
2.) nausea 3.) cytopenias 4.) liver cirrhosis |
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Leflunamide(Arava)
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arrests cell development of AI lymphocytes
RA: slows progression of DZ PK: Oral |
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SE of Leflunamide
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1.) HA
2.) Diarrhea 3.) Nausea 4.) Weight Loss 5.) alopecia, rashes TERATOGEN |
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Chloroquine
& Hydroxychloroquine |
Used for Malaria
anti-inflammatory action slows progression of bone lesions in RA: induces remission |
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SE of Chloroquine & Hydroxy
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1.) GI
2.) Blurry vision 3.) Pruritis |
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Penicillamine
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Cystine analog, slows RA progression
used after gold salts but before steroids |
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SE of Penicillamine
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1.) skin problems
2.) nephritis 3.) aplastic anemia |
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Gold Salts
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macrophages take up & supress phagocyte & Lysosomal NZY activity
USED LESS B/C OF $ and monitoring |
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Anti-cytokine therapies in RA
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cytokines play key role in DZ states
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Ethanercept
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Anti-cytokine
aka Embrel uses: RA and PA |
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mech of action of Ethanercept
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binds 2 TNF together making inactive
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SE of Ethenercept
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well tolerated
long term concern for tumor |
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Infliximab
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aka Remicade, anti-cytotoxic
Binds to TNF |
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Uses for Infliximab
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Chron's DZ for 6 week Tx
IV over 2 hrs |
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SE of Infliximab
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infection
cytopenias lymphoma |
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Adalimumab
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aka Humira, anti-cytotoxic
Binds TNF receptor site SQ |
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uses of adalimumab
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RA after DMAEDS fail
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Anakinra
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aka Kineret, anti-cytotoxicIL-1 antagonist
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What drug is used for acute gout?
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Indomethacin
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True or False
you can take ASA with inomethacin |
Fasle
they compete w/ UA for renal excretion |
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What drugs are used for chronic gout?
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Allopurinol
Uricosurics Colchicine |
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Allopurinol
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blocks synthof final steps of UA
Useful in Hx of UA stones |
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SE of Allopurinol
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GI
Rash |
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Uricosurics
Probenacid & Sulfinpyrazone |
increases excretion of UA and block renal absorption of UA
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Colchicine
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Maintnance
Blocks granulocyte mobility and cell division and production of leukotrienes |
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Autocoids & Antagonists
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Misoprostol
Prostaglandin replacement Cytotec |
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Uses of Misprostol
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protect stomach from NSAID
Abortifacient |
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Migraine medication
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Triptans & Hydroergotamine
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Triptans
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Sumatriptan(Imitrex)
Zolmitriptan(NO IN CAD) |
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How to Triptans & Hydroergotamines work?
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act on seratonin receptor subgroup found on nerve endings
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Dihydroergotamine
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similar action to triptans
Nausea most common side effect |
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Consider migrain Prophylaxis for;
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pts with 3+ migraines/month
impacting quality of life have >2 requireing intervention |
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what drug groups are used for prophylaxis?
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B-blockers: propanolol
Anticonvulsants:amitriptyline Ca channel bloackers: verapamil |
