Therapeutics - RA 3

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  1. The patient has failed on Hydroxychloroquine if no symptom relief has developed in _________.
    6 months
  2. What is the main advantage of Hydroxychloroquine?
    No myelosupression, hepatic or renal toxicities
  3. What are the adverse effects of Hydroxychloroquine?
    • GI distress
    • Ocular toxicities
    • Dermatologic
    • Neurologic
  4. What clinical monitoring is needed with Hydroxychloroquine treatment?
    • Baseline eye exam
    • Opthalmoscopy every 9-12 months for vision changes
  5. What is the Amsler grid?
    A grid used to test for ocular issues associated with Hydroxychloroquine use
  6. What is the usual dose for Sulfasalazine?
    • 500 mg PO BID
    • Titrate to 100 mg PO BID
  7. What is the onset of symptom relief for Sulfasalazine?
  8. Sulfasalazine is a prodrug cleaved in the intestines, what is the active form?
    • Sulfapyridine
    • 5-aminosalicylic acid
  9. Sulfasalazine has higher concentrations in certain tissues what are they?
    • Serous fluid
    • Liver
    • Intestines
  10. Does Sulfasalazine slow radiographic progression?
  11. What are the AE of Sulfasalazine?
    • GI
    • Dermatologic
    • Leukopenia
    • Hepatitis
  12. How should you monitor Sulfasalazine?
    CBC, AST and ALT
  13. 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
  14. TNF-alpha Biologics should be avoided with what concomitant disease state?
    • Stage 3 or 4 HF
    • Caution with stage 1 or 2
  15. What are the main risks of all Biologic DMARDs?
    • Infection
    • Malignancy
    • HF (TNF-alpha inhibitors)
  16. Why should you not use Biologic DMARDs in people with recent cancer?
    They block anti-cancer molecules and may cause malignancy
  17. Infliximab produces symptom relief for RA in what time period?
    3-7 days
  18. Adalimumab produces symptom relief for RA in what time period?
    3 months
  19. Can you combine TNF-alpha inhibitors with methotrexate?
  20. Can you combine TNF-alpha inhibitors with other biologic DMARDs?
Card Set
Therapeutics - RA 3
Therapeutics - RA 3
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