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64 Cards in this Set
- Front
- Back
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Cytokines released by T-cells leading to further joint inflammation in RA
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TNF, interleukins
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Disadvantage of using NSAIDs
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Don't alter the disease course
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Flector Patch
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Diclofenac
RA q12h |
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Pennsaid
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Diclofenac solution
For knees only |
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Lidone (XL)
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Etodolac
600mg-1200mg/d in bid or qid |
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Indocin (SR)
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Indomethacin
PO IV Supp 100-200mg/d Can cause more headaches |
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Felafen
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Nabumetone
NSAID |
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Tolectin
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Tolmetin
NSAID |
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Clinoril
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Sulindac
NSAID |
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Ibuprofen
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Max 3200mg/d in tid-qid
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Orudis
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Ketoprofen
Max 300mg/d in tid-qid |
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Oruvail
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Ketoprofen SR
100-200mg/d qd |
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Naprosyn
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Naproxen
500-1500mg/d in bid tid |
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Feldene
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Piroxicam
10-20mg/d qd bid |
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Celebrex
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Celecoxib
200-400mg/d qd bid |
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Mobic
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Meloxicam
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If pt is on high dose of NSAIDs think about giving this medication
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PPI, H2RA, misoprostol
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NSAIDS with high ulcer risk
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Piroxicam
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NSAID ADR
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Ulcers
Hepatic failure Renal blood flow decrease |
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What allergies must Celebrex be avoided in?
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Sulfa
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Advantages of using DMARD
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Preserve joint integrity and function
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Monotherapy for all categories of RA
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Methotrexate, Leflunomide
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Plaquenil
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Hydroxycloroquine
Decreases interleukin-1 from monocytes 200mg bid |
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Myochrisine
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Gold sodium thimalate
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Minocin
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Minocycline
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MTX sig DDI
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Bactrim (can cause added hematologic abnormalities)
NSAID and ASA can increase concentration |
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Folic Acid recommended doses for pt on MTX
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max 3mg/day
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All pts on DMARDs should recieve ___ prior to DMARD initiation
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vaccines
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MTX dose
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7.5-25.0mg po qwk
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Avara
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Pregnancy category X
If wish to get pregnany must follow drug elmination protocol |
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Avara ADR
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Diarrhea, LFT, alopecia, hypertension and rash.
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Avara DDI
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Increased liver tox when used in conjunction with MTX
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Avara elimination protocol
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8g of Questran tid for 11 days;
plasma levels of M1 > 0.02mg/L verified on 2 occasion 2 weeks apart. |
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Avara dosing
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100mg qd x3days, 20mg qday
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Cuprimine
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D-penicillamine
Thrombocytopenia Proteinuria Rash Stomatitis |
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Cuprimine administration
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TAKE ON EMPTY STOMACH
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Gold ADR
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RASH
sun sensitivity Protein/hema-uria Leukopenia |
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anti-TNF therapy for RA
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Enbrel
Remicade Adalimumab |
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Anti-TNF ADR
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INFECTIONS (no live vaccines)
Rash Nausea Cough |
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Enbrel
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Kineret
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100mg sc qd
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Orencia
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CI with other DMARDs
CI Live vaccines |
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Rituxan
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Last line therapy
Pre-medicate with glucocorticoid 1000mg q 2wk |
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Imuran
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Azothiaprine
50-150mg/d po qd bid CBC, creatinine, lft DDI with allopurinol |
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Hypertension
Nephrotoxicity Glucose intolerance Hepatoxicity |
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Hypertension
Nephrotoxicity Glucose intolerance Hepatoxicity |
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Pt on chronic glucocorticoid should recieve
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1500mg elemental calcium and 400-800IU of vitamin D/day
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Lifestyle modification in RA
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increase protein intake
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DOA for OA
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APAP
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Ultram (ER)
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400mg/day
Don't take with MAOI Constipation/ n/v, sz, and withdrawal sx |
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Chondroitin and Glucosamine DDI
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Warfain
May increase risk of bleeding |
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Colchicine for RA dose
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1.2mg po then 0.6mg 1hr later. Max 1.8mg over 1 hr.
IV PO Dose renally Most effective when given within 12-36 hours of attack |
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Colchicine indication
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chronic suppressive therapy for gout
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Colchicine ADR
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NVD, bloating.
Bone marrow suppresion Extravasation Don't give in PUD |
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Benemid
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Probenecid
Blocks uric acid uptake in proximal tubule |
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Benemid counseling
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Drink plenty of water to prevent stones
Don't use in gouty attack b/c it may exacerbate it. |
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Benemid DDI
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NTF decreased efficacy
Penicillin increased efficacy May increase [sulfonylurea] |
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During gouty attack what meds to give and which to avoid
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give: NSAIDs, Colchicine
avoid: probenecid |
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Benemid dose
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250-500 mg po bid
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Zyloprim
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Allopurinol
300mg po qd Rash |
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Uloric
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Febuxostat (Zyloprim like agent)
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Elitek
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Rasburicase (don't use in pt with G6PD)
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antiphosphoslid antibody (from SLE) increases the risk of ___
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Stroke
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Treatment of SLE
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Hydroxychloroquine
Glucocorticoid cyclophosphamide NSAIDs |
