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Phase 2- Gen Med > Rheumatology Drugs > Flashcards

Rheumatology Drugs Flashcards

1
Q

What type of drug is adalimumab?

A

anti-TNF drug

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2
Q

Which conditions have lots of TNF present?

A

Rheumatoid arthritis
Psoriatic arthritis
Ankylosing spondylitis
Juvenile idiopathic arthritis

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3
Q

What is adalimumab commonly prescribed with?

A

Methotrexate

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4
Q

What investigations need to be done before prescribing Adalimumab?

A

TB screen
Chest x-ray
Hepatitis screen

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5
Q

How is adalimumab administered?

A

SM injection every 2 weeks

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6
Q

Give 4 conditions where adalimumab would be contraindicated?

A 
Infection present 
Multiple sclerosis 
Cancer
Lung fibrosis
Heart disease
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7
Q

Give 4 side effects of adalimumab

A 
Injection site pain 
More at risk of infections 
Increased risk of skin cancer
More severe reaction to chickenpox and shingles
Drug-induced lupus
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8
Q

What enzyme does allopurinol inhibit?

A

Xanthine oxidase

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9
Q

What is allopurinol indicated for?

A

Prevention and treatment of recurrent gout
When gout has started to damage the joints
Tophi are present

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10
Q

Give 4 side effects of allopurinol

A 
Skin rashes
Headaches 
Drowsiness
Nausea 
Vomiting
Alteration in taste
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11
Q

Give 3 potential DDIs with allopurinol

A 
Azathioprine 
Mercaptopurine
Ampicillin 
Amoxicillin 
Warfarin
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12
Q

What type of drug is Azathioprine?

A

DMARD

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13
Q

In what conditions are DMARDs indicated?

A

SLE
RA
Polymyositis
Dermatomyositis

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14
Q

What enzyme should be checked before starting azathioprine?

A

TPMT

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15
Q

If the TPMT level is high, what should be done to the dose of azathioprine?

A

Need a higher dose as the drug is broken down quickly

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16
Q

If the TPMT level is low, what should be done to the dose of azathioprine?

A

Lower the dose as the drug is broken down more slowly and there is a higher risk of side effects

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17
Q

Give a DDI of azathioprine

A

Allopurinol

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18
Q

Give 4 potential side effects of azathioprine

A

Nausea, vomiting, diarrhoea, loss of appetite, hair loss, skin rashes, agranulocytosis, liver disease, severe reaction to chickenpox or shingles

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19
Q

What is the main action of bisphosphonates?

A

Slow bone loss to reduce the risk of fractures

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20
Q

Give 2 examples of bisphosphonates

A

Alendronic acid
Zoledronate
Pamidronate

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21
Q

Give 3 common side effects of bisphosphonates

A 
Oesophagitis
Rash 
Sore mouth 
Bone pain 
Muscle pain 
Headaches
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22
Q

Give 3 rare side effects of bisphosphonates

A

Osteonecrosis of the jaw
Esophageal cancer
Femur fractures

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23
Q

What is the mechanism of action of Celecoxib?

A

Selective COX II inhibitor

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24
Q

What type of drug is celecoxib?

A

NSAID

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25
Q

Give 3 contraindications to celecoxib

A

T3 pregnancy
Heart disease
GI bleeding
Allergy to aspirin or other NSAIDs

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26
Q

Give 3 potential DDIs with celecoxib

A

NSAIDs, alcohol, aspirin, warfarin, prednisolone, fluconazole, lithium

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27
Q

Give 4 potential side effects of celecoxib

A

Rash, cold-like symptoms, dizziness, stomach pain, SOB, stomach bleeds, liver problems, anaemia

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28
Q

What is calcitonin used for?

A

Short term treatment to prevent bone loss after an osteoporotic fracture

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29
Q

Give 3 potential side effects of calcitonin

A

Nausea, vomiting, diarrhoea, abdominal pain, dizziness, headache, taste disturbance

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30
Q

When are vitamin D and calcium supplements given?

A

Alongside osteoporosis medicine

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31
Q

What type of drug is ciclosporin?

A

DMARD

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32
Q

What conditions are indicated for ciclosporin?

A

RA
SLE
Psoriatic arthritis

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33
Q

Give 3 side effects of ciclosporin

A

Hypertension
Hypercholesterolaemia
Kidney damage
Worse reaction to chickenpox and shingles

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34
Q

Give 2 DDIs of ciclosporin

A

NSAIDs
Herbal remedies
Grapefruit juice

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35
Q

What is colchicine used for?

A

Acute flare ups of gout

36
Q

Give the 2 main side effects of colchicine

A

GI upset

Neutropenia

37
Q

Give 2 DDIs of colchicine

A

Erythromycin

Clarithromycin

38
Q

What type of drug is cyclophosphamide?

A

Immunosuppressant (alkylating chemotherapeutic drug)

39
Q

In what conditions is cyclophosphamide used in?

A

Severe RA
SLE
Vasculitis
Myositis

40
Q

Give 5 side effects of cyclophosphamide

A 
Nausea
More at risk of infections 
Hemorrhagic cystitis
Agranulocytosis
Hair loss 
Mouth ulcers
Irregular periods
Increased risk of bladder cancer
41
Q

What is febuxostat used for?

A

Long term prevention of gout

42
Q

When is febuxostat not indicated?

A

Previous MI
Severe kidney disease
Liver disease
Thyroid problems

43
Q

Give 4 possible side effects of febuxostat

A

Diarrhoea, headaches, skin rashes, nausea, taste disturbance, palpitations, reduced libido

44
Q

Give 3 DDIs of febuxostat

A

Azathioprine
Mercaptopurine
Theophylline

45
Q

What type of drug is Hydroxychloroquine?

A

DMARD

46
Q

What is the action of hydroxychloroquine?

A

Reduces inflammation
Reduces pain
Reduces swelling
Reduces joint stiffness

47
Q

What specific action can hydroxychloroquine have in lupus?

A

Reduce the rash associated with lupus

48
Q

What test must be done through treatment on hydroxychloroquine?

A

Vision tests

49
Q

Give 5 possible side effects of hydroxychloroquine

A

Rash, nausea, indigestion, diarrhoea, headaches, hair bleaching, hair loss, tinnitus, blurred vision, retinal damage

50
Q

Give 1 DDI of hydroxychloroquine

A

Antacids

51
Q

What type of drug is infliximab?

A

ANti-TNF

52
Q

When is infliximab contraindicated?

A

No active inflammation
Current infection
History of multiple sclerosis, cancer, heart disease, lung fibrosis

53
Q

Give 5 side effects of infliximab

A

Rhinorrhoea, headaches, dizziness, flushing, rash, stomach pain, indigestion, agranulocytosis, more severe reaction to chickenpox or shingles, drug-induced lupus

54
Q

What conditions is intravenous immunoglobulin used to treat?

A

Polymyositis
Dermatomyositis

Occasionally SLE, vasculitis, antiphospholipid syndrome

55
Q

When is intravenous immunoglobulin contraindicated?

A

Low levels of IgA

56
Q

Give 4 possible side effects of intravenous immunoglobulin

A

Chill, headaches, stomach pain, fever, nausea, vomiting, joint pain, tiredness, rash, aseptic meningitis, haemolytic anaemia, hypertension, increased risk of MI and stroke

57
Q

What type of drug is methylprednisolone?

A

Corticosteroid

58
Q

Why should methylprednisolone not be stopped suddenly?

A

Adrenal insufficiency (Addisonian crisis)

59
Q

Give 2 contraindications of methylprednisolone

A

Fungal infection

Diabetes

60
Q

Give 4 side effects of methylprednisolone

A 
Fluid retention 
Dizziness
Headache 
Changes in menstrual periods
Myalgia
Muscle weakness
Stomach pain 
Bloating 
Depression
61
Q

Give 4 effects of long term steroid use

A

Cushingoid appearance
OSteoporosis
Cataracts
Diabetes

62
Q

What type of drug is methotrexate?

A

DMARD

63
Q

How often is methotrexate taken?

A

Once a week

64
Q

Which supplement is often taken alongside methotrexate?

A

Folic acid

65
Q

When is methotrexate contraindicated?

A

Lung fibrosis

Emphysema

66
Q

Give 4 side effects of methotrexate

A

Nausea, vomiting, diarrhoea, mouth ulcers, hair loss, skin rashes, agranulocytosis, pneumonitis

67
Q

Give 3 DDIs with methotrexate

A 
Trimethoprim
Septrin
Phenytoin
Theophylline
Alcohol
68
Q

What type of drug is mycophenolate mofetil?

A

DMARD

69
Q

What is mycophenolate mofetil used to treat?

A

SLE
Scleroderma
Vasculitis

Also used after organ transplantation

70
Q

Give 4 side effects of mycophenolate mofetil

A 
Nausea
Diarrhoea 
Stomach pain 
Agranulocytosis
Increased risk of skin cancer
Liver disease
Kidney disease
71
Q

What is the main function of NSAIDs?

A

Reduce inflammation

Reduce pain

72
Q

Give 3 contraindications of NSAIDs

A 
High risk of GI bleed or ulceration 
Previous MI 
Peripheral vascular disease
Hypertension 
Hypercholesterolaemia 
Diabetes 
Kidney disease
73
Q

Why should children not take aspirin?

A

Risk of Reye’s syndrome

74
Q

Give 3 examples of NSAIDs

A

Ibuprofen
Naproxen
Aspirin

75
Q

What is the function of paracetamol?

A

Pain relief

76
Q

Why is paracetamol so dangerous in overdose?

A

Metabolites cause serious liver damage

77
Q

When is Raloxifene used?

A

To treat osteoporosis of the spine in postmenopausal women who have had fractures.

78
Q

Give 3 contraindications of Raloxifene

A

Older women
History of DVT
History of uterine cancer
Liver disease

79
Q

Give 3 side effects of Raloxifene

A

Hot flushes, leg cramps, swollen ankles, flu-like symptoms DVT

80
Q

What type of drug is Rituximab?

A

Biological therapy

81
Q

Give 3 contraindications of Rituximab

A 
No active disease
Infection present 
Pregnant
Breastfeeding 
B-cell levels low 
Seronegative RA
82
Q

Give 3 side effects of Rituximab

A 
Fever
Wheeze
Rash 
Postural hypertension 
Higher risk of infections 
Progressive multifocal leukoencephalopathy
83
Q

When are steroid injections used?

A

Painful joints in:
RA
Osteoarthritis

84
Q

What type of drug is sulfasalazine?

A

DMARD

85
Q

Give 3 side effects of sulphasalazine

A

Nausea, diarrhoea, stomach pain, dizziness, headaches, skin rashes, orange urine, yellow tears, abnormal LFTs and FBC, fall in sperm count

Phase 2- Gen Med (7 decks)

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