RA

• what are some causes of RA?

  unknown

  viruses, bacteria, or fungi

  genetic

  environmental factors
• how is Citrulline antibody (anti-CCP) helpful in identifying RA?

  unexplained joint inflammation

  cause of previous undx inflammatory wiht RA, RF are not present
• what indicates potentially more aggressive disease in RA?

  Citrulline antibodies
• what antibody felt to have represent early stages of RA?

  Citrulline antibodies
• What is Felt's Syndrome?

  decreased WBC and enlarged spleen that can cause increase risk of infections
• what is the classes of antiarthric drugs?

  DMARDs (nonbiologic, biologic, targets synthetic, and conventional)
• what glucocorticoids are used for RA?

  prednisone and prednisolone
• Meds that are nonbiologic DMARDs

  Hydroxychloroquine, Methotrexate, Sulfasalazine, Leflunomide
• what drug is the first line of treatment for RA?

  Methotrexate
• Sulfasalazine used to treat what disease and MOA?

  IBD

  antiinflammatory and immunomodulatory action
• What is Leflunomide MOA?

  inhibits dihydro-orotate dehydrogenase needed for t-cell proliferation
• Sulfasalazine 


  is preferred over methotrexate and leflunomide
• methotrexate 


  preferred over leflunomide due to lower cost and dosing flexibility
• hydroxychloroquine


  antimalarial actions and first line for SLE

  preferred DMARD treatment

  combined with methotrexate
• what is a major side effect of hydroxychloroquine?

  retinal damage

  blindness

  visual loss r/t dosage
• when taking hydroxychloroquine, what exam should be followed up with?

  ophthalmic exam before and after treatment
• biologic DMARDS


  Etanercept, Rituximab, Adalimumab
• Toclizumab and Saralumab are what inhibitors

  IL-6
• what is Etanercept MOA?

  inactivates TNF
• what is the BBW for Etancercept?

  serious infections due to immune suppressant
• what are drug interactions with Etancercept?

  live virus should be avoided

  clucocorticoids, methotrexate, tocilizumab, anakinra, and abatacept for increase risk of infection
• what is Rituximab MOA?

  reduces b lymphocytes
• what is Tocilizumab MOA?

  blocks receptor for IL-6
• what interleukin does Anakinra block?

  Interleukin-1
• what is Interleukin-6 MOA?

  a proinflammatory cytokine that helps mediate autoimmune attack against the joints
• What is Interleukin-1 MOA?


  a proinflammatory cytokine that play a central role in synovial inflammation and joint destruction
• Janus Kinase inhibitors


  intracellular enzymes that initate cytokine signaling as part of the singal transducer and activation of transcription pathway

  Tofacitinib

  Baricitinib