Ra Drugs 1

Front 1

criteria for complete clinical remission in RA. a minimum of ____ of the requirements must be fulfilled for at least _____ months in a patient with RA

Back 1

5 requirements
2 months

Front 2

name 6 of the criteria for complete clinical remission in RA

Back 2

-morning stiffness not > 15 min
-No fatigue
-no joint pain
-no joint tenderness or pain on motion
-no soft-tissue swelling in joints or tendon sheaths
-ESR < 30 mm/hr (females) or 20 mm/hr (males)

Front 3

NSAIDs do not modify the disease course of RA. true or false?

Back 3

true

Front 4

initial drug treatment for RA. symptomatic relief of pain and swelling only. anti-inflammatory and analgesic

Back 4

NSAID

Front 5

no differences in efficacy among NSAIDs for the treatment of RA. true or false?

Back 5

true

Front 6

6 risk factors for NSAID induced nephrotoxicity

Back 6

-concurrent diuretics
-CHF
-renal insufficiency
-Cirrhosis
-concomitant drugs that affect renal hemodynamics or nephrotoxins

Front 7

6 risk factors for NSAID G.I. side effects or complications.

Back 7

-prior G.I. event including ulcer or hemorrhage
-age > 60 years old
-high doses
-concurrent use of steroids
-concurrent use of anticoagulants
-other co-morbid conditions

Front 8

common NSAID drug-drug interactions with warfarin and other anti-platelet agents?

Back 8

increase the risk for bleeding and ulceration

Front 9

drug-drug interaction with concurrent use of NSAIDs with lithium?

Back 9

increased lithium levels by decreasing the clearance

Front 10

drug class of celebrex?

Back 10

COX-2 inibitor

Front 11

drug class of celecoxib

Back 11

COX-2 inhibitor

Front 12

at what dose of celebrex can anti-angiogenisis effects occur?

Back 12

400-800 mg BID

Front 13

DMARDs can alter the progression of RA. true or false?

Back 13

true

Front 14

drug class which may induce remission or optimal control of inflammatory joint disease?

Back 14

DMARDs

Front 15

DMARDs should be used before joints are damaged and within the first _____ months of therapy

Back 15

3

Front 16

DMARDs are slow acting drugs. they may take _____ weeks to ______ months for a response.

Back 16

2 weeks
6 months

Front 17

this drug is considered the "gold standard" of DMARDs for the treatment of RA?

Back 17

Methotrexate

Front 18

Methotrexate is generally for ________ to _________ presentations of RA.

Back 18

moderate to severe

Front 19

MOA of Methotrexate

Back 19

decreased T and B lymphocyte function;
folic acid antagonist, which interferes with purine biosynthesis

Front 20

Which DMARD decreases T and B lymphocyte function;
folic acid antagonist, which interferes with purine biosynthesis

Back 20

Methotrexate

Front 21

typical Methotrexate dosing for RA?

Back 21

5-25 mg once a week

Front 22

what supplement may be given to reduce adverse effects associate with methotrexate? ie. stomatitis, alopecia, and myelosuprression

Back 22

folic acid 1 mg daily

Front 23

Leflunomide dosing for the treatment of RA?

Back 23

100 mg load x 3 days
10-20 mg daily maintenance

Front 24

Leflunomide MOA?

Back 24

has antiproliferative effect on T-cells. inhibits the enzyme dihydroorate dehydrogenase, which is required for pyrimidine nucletide synthesis.

Front 25

this DMARD has antiproliferative effect on T-cells. inhibits the enzyme dihydroorate dehydrogenase, which is required for pyrimidine nucletide synthesis.

Back 25

Leflunomide (Araba)

Front 26

major adverse effect associated with Leflunomide (Araba)?

Back 26

hepatotoxicity

Front 27

monitoring parameters for Leflunomide?

Back 27

LFTs every month

Front 28

Leflunomide is safe for use during pregnancy? true or false

Back 28

false. its teratogenic Category X

Front 29

brand name of Leflunmide?

Back 29

Araba

Front 30

monitoring parameters for Araba?

Back 30

LFTs every month. pregnancy category X

Front 31

MOA of hydroxychloroquine (Plaquenil)

Back 31

inhibits macrophage/ B cell function

Front 32

generally a first line DMARD for milder presentations of RA?

Back 32

Hydroxychloroquine (Plaquenil)

Front 33

dose for hydroxychloroquine?

Back 33

200 mg PO BID

Front 34

dose for Plaquenil?

Back 34

200 mg PO BID

Front 35

brand name of hydroxychloroquine

Back 35

Plaquenil

Front 36

adverse effects associated with hydroxychloroquine?

Back 36

retinopathy (vision changes)

Front 37

which DMARD requires baseline eye examination and checks every 6-12 months?

Back 37

hydroxychloroquine (Plaquenil)

Front 38

Wilsons disease is associated with what toxicity?

Back 38

Copper

Front 39

Inhibits T cell proliferation by complexing with CU2+

Back 39

Penicillamine

Front 40

unpopular drug due to adverse effects: rash, stomatitis, dysgeusia (altered taste), myelosuppression

Back 40

Penicillamine

Front 41

inhibit macrophage and PMN activity, may decrease immune complex formation (IgG/IgM complexes)?

Back 41

Gold

Front 42

Inhibitor of lymphocyte proliferation

Back 42

Azathioprine

Front 43

calcineurin inhibitor, preenting the activations of T-cells

Back 43

Cyclosporine

Front 44

Cyclosporine dosing in RA

Back 44

3 mg/kg/day

Front 45

when naming monoclonal Ab meds, "i" refers to
a. mouse
b. human
c. gerbil/hamster
d. monkey/primate

Back 45

monkey/primate

Front 46

when naming monoclonal Ab meds, "e" refers to
a. mouse
b. human
c. gerbil/hamster
d. monkey

Back 46

gerbil/hamster ovaries

Front 47

when naming monoclonal Ab meds, "u" or "zu" refers to
a. mouse
b. human
c. gerbil/hamster
d. monkey

Back 47

human

Front 48

when naming monoclonal Ab meds, "a" or "axo" refers to
a. mouse
b. human
c. gerbil/hamster
d. rat

Back 48

rat

Front 49

binds specifically to TNF-alpha and neutralize the biological activity of pro-inflammatory cytokines. this decreases the infiltration of inflammatory cells into inflamed areas of the joints

Back 49

infliximab

Front 50

brand name of Infliximab

Back 50

Remicade

Front 51

brand name of Etanercept

Back 51

Enbrel

Front 52

brand name of Adalimumab

Back 52

Humira

Front 53

RA Tx drug class contraindicated in patients with an active infection?

Back 53

TNF-alpha inhibitors

Front 54

Infliximab, Etanercept, and Adalimumab belong to what class of drugs?

Back 54

TNF-alpha inhibitors

Front 55

before using TNF-alpha inhibitors, a patient should be tested for TB using the _______ panel and a PPD prior to administration of the drug

Back 55

Anargy

Front 56

infliximab is IV only? true or false

Back 56

true

Front 57

dose of infliximab for RA

Back 57

3 mg/kg IV over 2-4 hrs

Front 58

which TNF-alpha inhib come in SC formulations?
a. Infliximab
b. Etanercept
c. Adalimumab

Back 58

Etanercept
Adalimumab