BRAINSCAPE1
NR 565 Pharmacology Week 4
Exam with complete solutions
latest version
Most common inflammatory form of arthritis - CORRECT ANSWER-Gout
Characteristics: RA - CORRECT ANSWER-Rapid onset
3:1 in women/men
Age 35-50 years at onset
Affects hands and feet
local and systemic inflammation
60 mins morning joint stiffness
Symmetric
Elevated ESR
Leukocytosis
Systemic symptoms
RA symptoms - CORRECT ANSWER-Pain
Swelling
Warmth
Stiffness
Characteristics: Osteoarthritis - CORRECT ANSWER-Slow onset (years)
1:1 in men/women
Age > 50 years at onset
Affects hands, hips, knees
Mild or local inflammation
< 30 min morning joint stiffness
symmetric or asymmetric pattern
ESR normal
Mild leukocytosis
No systemic symptoms
BRAINSCAPE1
, BRAINSCAPE1
Symptoms: Osteoarthritis - CORRECT ANSWER-Pain
Bone enlargement
Treatment goals: RA - CORRECT ANSWER-Relieve symptoms
Maintain joint function and ROM
Decrease systemic involvement
Delay disease progression
Medications: RA - CORRECT ANSWER-NSAIDS
Glucocorticoids
Conventional DMARDS
Biologic DMARDS
Mechanism of action: Conventional DMARDs - CORRECT ANSWER-
Immunosuppressant
Inhibits dihydrofolate reductase
Inhibits lymphocyte proliferation
Folate antagonist
Mechanism of action: Bioloic DMARDs - CORRECT ANSWER-Inhibits JAK 1,2,3 =
disruption of cytokine and growth factor signaling pathways
Mechanism of action: Targeted DMARDs - CORRECT ANSWER-Binds to and inhibits
tumor necrosis factor alpha = decreased inflammation and altered immune response
Medications: Conventional DMARDs - CORRECT ANSWER-Methotrexate
Sulfasalazine (azulfidine)
Leflunomide (arava)
Hydroxychloroquine (plaquenil)
Medications: Biologic DMARDs - CORRECT ANSWER-Adalimumab (Humira)
Certolizumab pegol (cimzia)
Etanercept (Enbrel)
Golimumab (Simponi)
Medications: Targeted DMARDs - CORRECT ANSWER-Tofacitinib
Baricitinib
DMARD prescribing considerations - CORRECT ANSWER-Obtain baseline CBC
w/WBC differential
Assess for s/s of infection (TB/hepatitis) and malignancies
R/O pregnancy
Assess risk for immunocompetence (liver/renal status)
Comprehensive H+P to establish baseline
Screen for TB
BRAINSCAPE1
NR 565 Pharmacology Week 4
Exam with complete solutions
latest version
Most common inflammatory form of arthritis - CORRECT ANSWER-Gout
Characteristics: RA - CORRECT ANSWER-Rapid onset
3:1 in women/men
Age 35-50 years at onset
Affects hands and feet
local and systemic inflammation
60 mins morning joint stiffness
Symmetric
Elevated ESR
Leukocytosis
Systemic symptoms
RA symptoms - CORRECT ANSWER-Pain
Swelling
Warmth
Stiffness
Characteristics: Osteoarthritis - CORRECT ANSWER-Slow onset (years)
1:1 in men/women
Age > 50 years at onset
Affects hands, hips, knees
Mild or local inflammation
< 30 min morning joint stiffness
symmetric or asymmetric pattern
ESR normal
Mild leukocytosis
No systemic symptoms
BRAINSCAPE1
, BRAINSCAPE1
Symptoms: Osteoarthritis - CORRECT ANSWER-Pain
Bone enlargement
Treatment goals: RA - CORRECT ANSWER-Relieve symptoms
Maintain joint function and ROM
Decrease systemic involvement
Delay disease progression
Medications: RA - CORRECT ANSWER-NSAIDS
Glucocorticoids
Conventional DMARDS
Biologic DMARDS
Mechanism of action: Conventional DMARDs - CORRECT ANSWER-
Immunosuppressant
Inhibits dihydrofolate reductase
Inhibits lymphocyte proliferation
Folate antagonist
Mechanism of action: Bioloic DMARDs - CORRECT ANSWER-Inhibits JAK 1,2,3 =
disruption of cytokine and growth factor signaling pathways
Mechanism of action: Targeted DMARDs - CORRECT ANSWER-Binds to and inhibits
tumor necrosis factor alpha = decreased inflammation and altered immune response
Medications: Conventional DMARDs - CORRECT ANSWER-Methotrexate
Sulfasalazine (azulfidine)
Leflunomide (arava)
Hydroxychloroquine (plaquenil)
Medications: Biologic DMARDs - CORRECT ANSWER-Adalimumab (Humira)
Certolizumab pegol (cimzia)
Etanercept (Enbrel)
Golimumab (Simponi)
Medications: Targeted DMARDs - CORRECT ANSWER-Tofacitinib
Baricitinib
DMARD prescribing considerations - CORRECT ANSWER-Obtain baseline CBC
w/WBC differential
Assess for s/s of infection (TB/hepatitis) and malignancies
R/O pregnancy
Assess risk for immunocompetence (liver/renal status)
Comprehensive H+P to establish baseline
Screen for TB
BRAINSCAPE1
