Shared Flashcard Set

Details

Pharm- Gout/OA/RA
MSK week 3
42
Medical
Graduate
08/22/2018

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Cards

Term
What are common CNS adverse fx of NSAIDs?
Definition
Headache, tinnitus, dizziness
Term
Prostaglandins responsible for pain, inflammation & fever are produced by which COX enzyme?
Definition
COX-2
Term
Does aspirin block COX-1 and 2 reversibly or irreversibly?
Definition
Irreversibly
Term
Diclofenac indications
Definition
OA, RA, migraines, ankylosing spondylitis
Term
Which NSAID is indicated for pericarditis?
Definition
Ibuprofen
Term
Which NSAIDs are indicated in acute gouty arthritis?
Definition
Indomethacin; naproxen
Term
Which NSAID is most lipophilic (more able to cross blood-brain barrier into CNS)?
Definition
Indomethacin
Term
Which NSAID is associated w/ pancreatitis and renal papillary necrosis?
Definition
Indomethacin
Term
Which NSAID is most associated w/ LFT abnormalities?
Definition
Diclofenac
Term
Which NSAID is associated w/ pseudoporphyria and photosensitivity?
Definition
Nabumetone
Term
Which has slight preference for COX-1 inhibition: celecoxib or meloxicam?
Definition
Meloxicam
Term
What is methotrexate's MOA?
Definition
AICAR enzyme -> increased AMP -> adenosine inhibits inflammation
Term
Is methotrexate more helpful in an acute RA flare or for chronic RA management?
Definition
Chronic mgmt; in acute flare, add NSAIDs or glucocorticoids
Term
What are the most common toxicities associated w/ methotrexate?
Definition
Hematologic (anemia, leukopenia), GI, hepatic (check LFTs), pulmonary (hypersensitivity rxn)
Term
Best way to avoid methotrexate toxicities?
Definition
Administer w/ folic acid
Term
What is the major metabolite of azathioprine?
Definition
6-thioguanine
Term
Which nonbiologic DMARD is first line treatment for RA?
Definition
Methotrexate
Term
Which nonbiologic DMARD is mostly prescribed in solid organ transplant?
Definition
Cyclosporine
Term
Unique toxicities of cyclosporine?
Definition
Cardiotoxicity, infertility w/ chronic use
Term
Which DMARD is associated w/ diarrhea, mild alopecia, teratogenicity and weight gain toxicities?
Definition
Leflunomide
Term
Which DMARD inhibits JAK enzymes?
Definition
Tofacitinib
Term
Examples of nonbiologic DMARDs?
Definition
Methotrexate, azathioprine, cyclosporine, leflunomide, sulfasalazine, tofacitinib
Term
With which DMARD do we need to monitor lipid panels?
Definition
Tofacitinib
Term
Abatacept MOA?
Definition
Binds to CD80/86 receptor on Antigen Presenting Cell -> prevents T-cell activation and thus inflammation
Term
Rituximab MOA?
Definition
Targets CD20 B lymphocytes -> apoptosis -> decreased inflammation
Term
What is a common adverse effect of DMARDs?
Definition
Increased risk of infection
Term
Tocilizumab MOA?
Definition
Binds to IL-6 receptors
Term
Most common biologic DMARD class used to treat RA? + examples
Definition
TNF-alpha blockers (e.g. adalimumab, etanercept, infliximab)
Term
Which DMARDs are indicated in ulcerative colitis?
Definition
Adalimumab/"Humira", infliximab
Term
Which DMARD is a chimeric IgG monoclonal antibody?
Definition
Infliximab
Term
Which drug class of DMARD is associated w/ drug-induced lupus and antidrug antibodies?
Definition
TNF-alpha blockers (adalimumab, etanercept, infliximab)
Term
What type of crystals are deposited in the joints in gout?
Definition
Monosodium urate
Term
What is colchicine's MOA?
Definition
Binds to tubulin in neutrophils
Term
Which gout med was first extracted from Autumn Crocus flower?
Definition
Colchicine
Term
Which med dose was historically titrated up until the pt had diarrhea (GI toxicity common)?
Definition
Colchicine
Term
Which Gout med is also indicated in Familial Mediterranean Fever?
Definition
Colchicine
Term
Probenecid MOA?
Definition
Prevents reabsorption of uric acid in PCT of kidney
Term
Which gout med can prolong penicillin serum levels?
Definition
Probenecid
Term
MOA of allopurinol?
Definition
Converted to active metabolite: alloxanthine -> blocks xanthine oxidase from forming uric acid
Term
Which gout med is also indicated in cancer-induced hyperuricemia?
Definition
Allopurinol
Term
Should you d/c allopurinol therapy in a pt that develops a rash from the medication?
Definition
Yes
Term
Which gout med inhibits urate crystal phagocytosis?
Definition
Indomethacin
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