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NURS 572 Pharm 72RA
Pharm - rheumatoid arthritis RA
Question | Answer |
---|---|
Three classes of drugs to tx RA | NSAIDs---DMARD = disease modifying anti-rheumatic drug-----gluco/cortio/steroids |
role of NSAIDs in RA | treat symptoms only ---DO NOT SLOW PROGRESSION OF DISEASE |
role of DMARDs in RA | used to slow progression of RA |
role of steroids in RA | used to 'bridge' while waiting for DMARDs onset. only used ST and/or for severe sxs until they are releived by DMARD or NSAID |
DMARDs take weeks/months for onset to decrease inflamm and dec progression. What is normal admin route | this class generally given orally. (mothotrexate does have an inj form) |
Name 3 oral DMARDs | methotrexate---hydroxychloroquine---sulfasaline---leflunomide |
what oral DMARD used first and why | methotrexate ---it only takes 3-6 WEEKS for its onset |
moethotrexate ADRs - serious but less prevalent than other DMARD ADRs | hepatic fibrosis---bone marrow suppression---GI ulceration---pneumonitis |
name oral DMARD whose onset is 3-6 MONTHS | Hydroxychloroquine ----also used to tx malaria |
ADR concern for hydroxychloroquine | toxicity--> RETINAL DAMAGE. monitor with ophtalmogic evaulations |
what oral DMARD has onset of 1-3 MONTHS | sulfasalazine ---but it is least effective in class |
unusual ADRs sulfasalazine | compliance limiting GI & dermatologic---hepatitis and BMD are rare |
DMARDs that are biological agents, MOA | suppresses various components of immune system |
very important ADR of biological DMARDS | by suppressing immune system --> SUSCEPTIBLE TO INFECTION, INCLUDING SEPSIS |
are biological DMARDs first line? | no, but are useful if oral DMARDs not successful |
leflunomide is an oral DMARD, classified as non-biological but it decreases Tcell prolif, so is likely to have this ADR | LEST LIKELY infection in pseudo-class --- along with d/n---rash/alopecia |
what are the IV admin biological DMARDs | infliximab---tocilizumab |
what are the SQ injectible 'mab DMARD-biological | adalimumab---golimumab---rituximab |
what are the SQ injectble 'cept DMARD-biological | etanercept---abatacept |
what is the 'oddball named' SQ DMARD-biological | anakinra |