pharm chap 16

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Author:
vongc2
ID:
66216
Filename:
pharm chap 16
Updated:
2011-02-14 00:55:16
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pharm chap 16
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Description:
management of RA and OA
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  1. name 4 glucocorticoids
    • prednisone
    • cortisone
    • hydrocortisone
    • dexamethasone
  2. chlorquine
    and
    hydroxychloroquine
    • (aralen)
    • (plaquenil)
    • DMARD
    • MAO- depressed t cell stimulation (immunosuppression)
    • safest of DMARDs
    • a.r.- irreversible rentinal toxicity
  3. azathioprine
    • (imuran)
    • DMARD
    • prevents tissue rejection (immunosupprestion)
    • moa-inhibits lymphocyte proliferation
    • a.r.-relatively toxic, fever, chills, sore throat, fatigue
  4. auranofin
    • (ridaura)
    • DMARD
    • gold therapy, no longer used
    • moa-inhibits t cells and phagocytes
    • a.r.- used fairly early, 1/3 exp. toxic effect- GI distress, rashes and itching
  5. leflunomide
    • (Arava)
    • DMARD
    • slows formation of bone erosions within 1 month
    • moa-inhibits RNA synthesis in lymphocytes (reduces jnt inflammation)
    • a.r.- GI distress, allergic reactions and hair loss
  6. methotrexate
    • (folex, Rheumatrex)
    • DMARD
    • decreases synovitis and bone erosion
    • antimetabolite/anticancer
    • most effective DMARD used first in treatment
    • moa- impairs DNA and RNA synthesis, inhibits folic acid synthisis, increases adenosine which inhibits immune response
    • a.r.- relativley toxic,
    • GI, pulmonary, hematolgic, liver and hair loss problems.
  7. penicillamine
    • (cuprimine)
    • DMARD
    • derivative of penicillin
    • moa-depresses t-cell function
    • a.r.- fairly toxic, used rarely
    • causes fever, jnt pain, rashes and itching
  8. etanercept
    • (Enbrel)
    • DMARD
    • Tumor necrosis factor inhibitor
    • moa-binds to TNF-alpha (TNF promotes inflammation and jnt erosion)
    • AR- prone to upper respiratory tract infections, liver disease, heart failure
  9. anakinra
    • (kineret)
    • DMARD
    • blocks effect of interleukin-1
    • (interleukin-1- cytokine that promotes jnt inflammation)
    • ar.- pts. may be more vulnerable to bacterial infections

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