Biologic DMARDs

Play an AI-generated podcast conversation about this lesson

What is the primary adverse reaction associated with Biologic DMARDs mentioned in the text?

Elevated liver function tests (correct)

Hypertension

Hyperlipidemia

Infusion-related and injection site reactions

Which enzymes modulate immune cell activity by responding to inflammatory mediators?

Kinase C

Proteasome

Janus kinases (correct)

Lipase

What laboratory parameter should be greater than 9 g/dL to start Tofacitinib therapy?

Platelet count

Neutrophil count

Lymphocyte count

Hemoglobin concentration (correct)

Which of the following agents is usually reserved for RA patients with inadequate response or intolerance to other drugs?

Tofacitinib Signup and view all the answers

What risk is associated with Tofacitinib treatment according to the text?

Increased risk for new primary malignancy Signup and view all the answers

In which group of patients is Tofacitinib indicated for the treatment of RA?

Patients with severe established RA and inadequate response to methotrexate Signup and view all the answers

Which proinflammatory cytokines are involved in the pathogenesis of rheumatoid arthritis?

IL-1 and TNF-α Signup and view all the answers

What is the main function of IL-1 and TNF-α when secreted by synovial macrophages?

Degradation of cartilage Signup and view all the answers

Which group of biologic DMARDs includes abatacept and rituximab?

Non-TNF biologic agents Signup and view all the answers

What effect have TNF-α inhibitors shown in the treatment of rheumatoid arthritis?

Decrease in signs and symptoms, reduction in structural damage, and improved physical function Signup and view all the answers

In which condition should TNF-α inhibitors be used cautiously?

Heart failure Signup and view all the answers

When can a clinical response be observed with TNF-α inhibitors therapy?

Within 2 weeks Signup and view all the answers

Which type of infections are patients receiving biologic DMARDs at an increased risk for?

Tuberculosis, fungal opportunistic infections, and sepsis Signup and view all the answers

Why should live vaccinations not be administered to patients taking biologic DMARDs?

To prevent the risk of severe infections Signup and view all the answers

What is the mechanism of action of Adalimumab in the treatment of RA?

Binds to TNF-α and interferes with its activity Signup and view all the answers

What is the frequency of administration for Certolizumab in patients with RA?

Every 2 weeks Signup and view all the answers

Why should TNF-α inhibitors and non-TNF biologic agents not be used together?

Due to the risk of severe infections Signup and view all the answers

What is the role of Etanercept in the treatment of RA?

Binds to TNF-α and blocks its interaction with cell surface receptors Signup and view all the answers

What is the mechanism of action of Allopurinol?

Competitive inhibition of xanthine oxidase Signup and view all the answers

Which condition warrants caution when using Allopurinol?

Cardiovascular disease Signup and view all the answers

What is the primary metabolite of Allopurinol?

Alloxanthine Signup and view all the answers

In which population should dosage adjustments be considered for Allopurinol?

Patients with severe renal impairment Signup and view all the answers

What is the therapeutic use of Allopurinol?

Treatment of gout and hyperuricemia Signup and view all the answers

How is Allopurinol primarily eliminated from the body?

Excreted in the urine Signup and view all the answers

What is the main characteristic of gout?

High levels of uric acid in the blood Signup and view all the answers

Which of the following is not a symptom commonly associated with acute flares of gout?

Yellow discoloration of the skin Signup and view all the answers

What is the primary cause of hyperuricemia in gout?

Inability to excrete uric acid renally Signup and view all the answers

What is the main goal of most therapeutic strategies for gout?

Lowering the uric acid level below 6 mg/dL Signup and view all the answers

What are some common triggers for acute gout attacks?

Excessive alcohol consumption Signup and view all the answers

Which of the following is effective for managing acute gouty arthritis?

NSAIDs Signup and view all the answers

What is the primary mechanism of action of colchicine?

Depolymerization of microtubules Signup and view all the answers

Which enzyme is responsible for the metabolism of colchicine?

CYP450 3A4 Signup and view all the answers

What is the primary therapeutic use of colchicine in gout management?

Alleviating pain during acute gout attacks Signup and view all the answers

What side effect can chronic administration of colchicine lead to?

Myopathy Signup and view all the answers

How is colchicine primarily eliminated from the body?

Renal excretion Signup and view all the answers

What is one common adverse effect associated with colchicine administration?

Neutropenia Signup and view all the answers

Why is colchicine not frequently used for acute gouty attacks anymore?

Safety concerns Signup and view all the answers

In what time frame should colchicine be administered to be effective during an acute gout attack?

< 12 hours after onset Signup and view all the answers

What is the main consequence of colchicine binding to mitotic spindles?

Cellular division inhibition Signup and view all the answers