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Peter Shared "DMARDs/NSAIDs" - 13 Picmonics

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DMARDs/NSAIDs

TNF-Alpha Inhibitors Overview
Mechanism
Downregulates Pro-inflammatory Cytokines
Decreased Lymphocyte Activation and Migration
Granuloma Breakdown
Treats
Crohn's Disease
Rheumatoid Arthritis
Juvenile Rheumatoid Arthritis
Psoriasis
Ankylosing Spondylitis
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1 min
TNF-Alpha Inhibitor Drugs and Complications
Etanercept
Decoy TNF- Alpha receptor
Anti-TNF- Alpha antibody
Adalimumab
Infliximab
Complications
Increased risk of infection
Predispose to Tuberculosis (TB) reactivation
Order Baseline PPD- skin test
Quantiferon Gold In-Tube
Order Chest X-Ray
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2 mins
Rheumatoid Arthritis Interventions
Lifestyle Modifications
Heat and Cold Applications
Therapeutic Exercise
Balance Rest and Activity
Drug Therapy
NSAIDs
DMARDs
Glucocorticoids
Considerations
PT/OT
Reconstructive Joint Surgery
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2 mins
Prednisone (Glucocorticoids)
Mechanism
Glucocorticoid
Indications
Inflammatory Conditions
Organ Transplant Rejection
Side Effects
Cataracts and Glaucoma
Cushing's Syndrome
Osteoporosis
Immunosuppression
Hyperglycemia
Ulcers
Considerations
Adrenal Insufficiency
Taper Gradually
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2 mins
Methotrexate
Indications
Rheumatoid Arthritis
Cancer
Medical Abortion
Mechanism
Folic Acid Analog
Inhibits Dihydrofolate Reductase
Side Effects
Pulmonary Fibrosis
Myelosuppression is Treated with Leucovorin Rescue (Folinic Acid)
Macrocytic Anemia
Hepatitis
Teratogenic
Mucositis
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2 mins
Leflunomide
Use And Mechanism
Immunosuppressant Used In Rheumatoid Arthritis
DMARD
Inhibits Dihydroorotate Dehydrogenase
Blocks Pyrimidine Synthesis And T-Cell Proliferation
Adverse Effects
Hepatotoxicity
Bone Marrow Suppression
GI Upset
Alopecia
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4 mins
Hydroxychloroquine
Mechanism of Action
Immunosuppressant
Indications
Malaria
Rheumatoid Arthritis
Systemic Lupus Erythematosus (SLE)
Porphyria Cutanea Tarda
Side Effects
Cardiotoxicity
Retinopathy
Considerations
Ophthalmological Exams
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3 mins
Azathioprine (Imuran)
Mechanism
Antimetabolite
Prodrug of 6-mercaptopurine (6-MP)
Inhibits Synthesis of Nucleic Acids
Indications
Autoimmune Disorders
Kidney Transplantation
Side Effects
Myelosuppression
Increased Toxicity with Allopurinol Use
Pancreatitis
Malignancy
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3 mins
NSAIDs
Indications
Anti-inflammatory
Analgesic
Fever
Closure of Patent Ductus Arteriosus
Mechanism of Action
Reversible Inhibition of COX-1 and COX-2
Block Prostaglandin Synthesis
Side Effects
Interstitial Nephritis
Gastric Ulcer
Renal Ischemia
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1 min
Aspirin
Indications
Fever
Pain and Headache
Cardiovascular Disease (CAD)
Mechanism of Action
Irreversible inhibition of COX-1 and COX-2
Suppress Thromboxanes and Prostaglandins
NSAID
Side Effects
Reye's Syndrome
Tinnitus
Peptic Ulceration
Mixed Acidosis/Alkalosis
Nephropathy
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2 mins
Ibuprofen (Advil, Motrin)
Mechanisms
NSAID
COX Inhibitor
Indications
General Pain
Fever
Inflammatory Conditions
Side Effects
GI Ulcers
Nephrotoxicity
Rash
Considerations
Avoid with Alcohol
Risk of Thrombotic Event
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2 mins
Acetaminophen
Indications
Fever
Pain
Mechanism of Action
Reversibly Inhibits COX
Acts Primarily in CNS
Side Effect
Hepatic Necrosis
N-acetylcysteine Antidote
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51 secs
Reye's Syndrome
Cause
Aspirin (Salicylates) to Treat Viral Illness (In Children)
Assessment
Cerebral Edema
Lethargy (Decreased LOC)
Vomiting
Liver Failure
Interventions
Monitor for Increased ICP
Mannitol (Osmitrol)
Considerations
No Aspirin for Children
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2 mins

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