Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
10 Cards in this Set
- Front
- Back
|
Rheumatoid Arthritis |
Chronic systemic inflammatory autoimmune disorder characterized by symmetrical inflammation of multiple joints Extra articular manifestations rheumatoid nodules, vasculitis, eye inflammation , neurological dysfunction, cardiopulmonary disease, lymphadenopathy, splenomegaly Progressive damage to soft tissue, cartilage, and bone without treatment |
|
|
RA pathophysiology |
Chronic inflammation of the synovial tissue lining the joint capsule results in proliferation of the tissue. -PTO inflammatory cytokines, tumor necrosis factor and interleukin -1 -activated T cells and B cells - most patients have antibodies called rheumatoid factors The inflamed synovium invades thé cartilage and bone surface producing erosions of bone and cartilage leading to destruction of joint |
|
|
Goals of therapy with RA |
Minimize disease activity and joint damage Enhance physical function and quality of life Maximize duration of remission Disease remission |
|
|
Médications for RA |
NSAIDS and other medications: Do not prevent or slow joint destruction —non selective NSAIDS, COX 2 selective inhibitors, steroids |
|
|
Médications for RA |
NSAIDS and other medications: Do not prevent or slow joint destruction —non selective NSAIDS, COX 2 selective inhibitors, steroids |
|
|
Disease Modifying AntiRheumatic Drugs (DMARDS) |
MTX Hydroxychloroquine Sulfasalazine Leflunomide Biological modifiers Gold Azathioprine Cyclosporine Cyclophosphamamide Penicillamine |
|
|
DMARDs |
- should initiate within the first 3 months of symptom onset - given to reduce mortality and prevent progresssion of RA -onset: delayed weeks to months before benefit seen—no direct analgesic or anti-inflammatory effect -narrow range of effectiveness Unique adverse event profile: use often limited by toxicities Consists of nonbiologic and biologic agents |
|
|
MTX |
First line DMARD for all patients Onset 2-3wks (max 4-6wks) Low cost: oral or SQ Administer once weekly |
|
|
MTX mechanism |
Folic acid antagonist, immunosuppressant, inhibits T lymphocytes proliferation and cytokine production |
|
|
Hydroxychloroquine |
Limited ability to prevent joint damage when used as mono therapy Mechanism- unknown Has some inflammatory properties |
