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Therapeutics - RA 3
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The patient has failed on Hydroxychloroquine if no symptom relief has developed in _________.
6 months
What is the main advantage of Hydroxychloroquine?
No myelosupression, hepatic or renal toxicities
What are the adverse effects of Hydroxychloroquine?
GI distress
Ocular toxicities
Dermatologic
Neurologic
What clinical monitoring is needed with Hydroxychloroquine treatment?
Baseline eye exam
Opthalmoscopy every 9-12 months for vision changes
What is the Amsler grid?
A grid used to test for ocular issues associated with Hydroxychloroquine use
What is the usual dose for Sulfasalazine?
500 mg PO BID
Titrate to 100 mg PO BID
What is the onset of symptom relief for Sulfasalazine?
2months
Sulfasalazine is a prodrug cleaved in the intestines, what is the active form?
Sulfapyridine
5-aminosalicylic acid
Sulfasalazine has higher concentrations in certain tissues what are they?
Serous fluid
Liver
Intestines
Does Sulfasalazine slow radiographic progression?
Yes
What are the AE of Sulfasalazine?
GI
Dermatologic
Leukopenia
Hepatitis
How should you monitor Sulfasalazine?
CBC, AST and ALT
What DDIs does Sulfasalazine have?
Warfarin is displaced from protein by sulfasalazine
Antibiotics can thwart prodrug activation in the intestines
Iron chelates Sulfasalazine and decrease its absorption
TNF-alpha Biologics should be avoided with what concomitant disease state?
Stage 3 or 4 HF
Caution with stage 1 or 2
What are the main risks of all Biologic DMARDs?
Infection
Malignancy
HF (TNF-alpha inhibitors)
Why should you not use Biologic DMARDs in people with recent cancer?
They block anti-cancer molecules and may cause malignancy
Infliximab produces symptom relief for RA in what time period?
3-7 days
Adalimumab produces symptom relief for RA in what time period?
3 months
Can you combine TNF-alpha inhibitors with methotrexate?
Yes
Can you combine TNF-alpha inhibitors with other biologic DMARDs?
No
Author
kyleannkelsey
ID
282086
Card Set
Therapeutics - RA 3
Description
Therapeutics - RA 3
Updated
2014-09-04T17:09:04Z
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