Hosam Mohamed-
converting a protein amino acid side from arginine to citrulline
What is Citrullination?
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genetically predisposed; environmental
Rheumatoid arthritis is considered to occur when ___________ individuals are exposed to specific ___________ risk factors.
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Anti-citrullinated protein antibodies
-autoantibodies produced by B-cells that are directed against self-proteins that are citrullinated.
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number of tender joints, global activity of symptoms, ESR
What does the Disease Activity Score measure?
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Erythrocyte sedimentation rate
-measures the degree of inflammation in the joints by taking out blood and placing it in a small, thin tube and the distance the RBCs settle in one hour is measure. mm/hr
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remission
-defined as the absence of signs and symptoms of inflammatory disease activity; or low disease activity as a goal.
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slowing of disease progression & maintaining function
The goal(s) for RA patients is what?
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JAK inhibitors & PDE4 inhibitors
What are our tsDMARD's?
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methotrexate
What is our csDMARD?
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AICAR transformylase; adenosine deaminase; inhibit neutrophils
Methotrexate inhibits __________ leading to the accumulation of AICAR. AICAR inhibits ____________. This leads to increased production of adenosine which will ___________.
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citinib
How can we tell if a drug is a JAK inhibitor? What suffix?
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milast
How can we tell if a drug is PDE4 inhibitor? What suffix
-
cAMP
Elevated levels of ______ leads to reduction of pro-inflammatory cytokines.
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d
Which drug should you carefully weigh the risks & benefits of treating when the patient has depression?
a) Barcitinib
b)Tofacitinib
c) Methotrexate
d) Apremilast
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d
Which drug requires prescribers to monitor weight regularly?
a) Barcitinib
b)Tofacitinib
c) Methotrexate
d) Apremilast
-
false; patients do not respond well
When it comes to treating ACPA+ patients, MTX monotherapy is sufficient. True or false?
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prevent inflammatory cytokine signaling by blocking phosphorylation of STAT
How do JAK inhibitors work?
-
Ulcerative colitis, PsA
What are other indications for Tofacitinib (XELJANZ)?
-
opportunistic infection & cardiovascular disease
What are Box warnings associated with JAK inhibitors?
-
CYP3A4; CYP2C19
Tofacitnib is metabolized by what enzymes?
-
a
Which drug is selective for JAK1/JAK2?
a) Barcitinib
b)Tofacitinib
c) Methotrexate
d) Apremilast
-
b
Which drug is a Pan-inhibitor (non-selective) JAK?
a) Barcitinib
b)Tofacitinib
c) Methotrexate
d) Apremilast
-
b
Which drug was found to increase risk of lung blood clots and had a dose reduction from 10 mg twice daily to 5mg twice daily?
a) Barcitinib
b)Tofacitinib
c) Methotrexate
d) Apremilast
-
a
Which drug has been approved as the first systemic treatment of Alopecia?
a) Barcitinib
b)Tofacitinib
c) Methotrexate
d) Apremilast
