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Rheumatoid Arthritis
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What are the sx of RA?
Slow insidious onset
Symmetrical presentation
Inflammation
Joint pain
Edema
Warmth
Erythema
MCP and PIP joints
Grip weakness
Functional difficulties
Deformities
Rheumatoid nodules
Vasculitis
Pulmonary fibrosis
Pleural effusions
Felty's Syndrome (triad of RA, splenomegaly, and neutropenia)
Which agents used to treat RA are adjunctive therapy?
NSAIDs
Corticosteroids
Which agents used to treat RA are disease-modifying?
DMARDs
What is the MOA of NSAIDs in RA?
Inhibition of COX to assist with reducing pain, stiffness and inflammation
What are the SE of NSAIDs?
GI upset and ulceration
Renal toxicity
What other analgesics may be used for pain relief in RA?
Tramadol
Opioids
What are the NSAIDs used in RA?
Low-dose ASA
Ibuprofen
Naproxen
Indomethacin
Etodolac
Diclofenac
Nabumetone
Meloxicam
Celecoxib
What are oral corticosteroids used for in RA?
Bridging therapy
Continuous low-dose therapy
Short-term bursts for flare-ups
What are injectable corticosteroids used for in RA?
Less frequent dosing
IM depots up to 6wks
IA depots a few months
What are the limiting SE of corticosteroid therapy in RA?
osteoporosis
Skin thinning
How long does it take to see benefit from DMARDs in RA?
weeks to months
How are DMARDs used in combination therapy in RA?
Never more than one Biologic agent
2-3 non-biologics
Non-biologics + 1 biologic
When are biologic DMARDs typically used in RA?
After failure or intolerability of non-biologics
What are the non-biologic DMARDs used in RA?
Methotrexate (DOC)
Leflunomide (2nd line)
Sulfasalazine
Hydroxychloroquine
Minocycline
Gold
Cyclosporine
Azathioprine
D-Penicillamine
What are the recommended non-biologic DMARD combinations for RA?
MTX + HCQ and/or SSZ
SSZ + HCQ
What are the biologic DMARDs used in RA?
Etanercept
Infliximab
Adalimumab
Golimumab
Certolizumab pegol
Abatacept
Rituximab
Tocilizumab
Anakinra
Author
giddyupp
ID
75130
Card Set
Rheumatoid Arthritis
Description
Rheumatoid Arthritis
Updated
2011-03-25T05:30:21Z
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