Midterm Exam (Latest )
Chamberlain
Foundations, Cards, Pain, MuscSkel & Rheumatologic
Question:
Glucocorticoids + Thiazides & Loops = ???
Answer:
increased risk of hypokalemia
Question:
glucocorticoids + vaccines = ???
Answer:
decreased efficacy of vaccines
,Question:
glucocorticoids + NSAIDs = ???
Answer:
GI ulcers and bleeding
Question:
glucocorticoids + insulin & oral hypoglycemics = ???
Answer:
gluconeogenesis and decreased peripheral glucose uptake
Question:
Glucocorticoid Adverse Effects (4)
Answer:
osteoporosis
myopathy
growth delays in children
eye problems: cataracts and glaucoma
,Question:
Methotrexate (Rheumatrex) MOA
Answer:
directly diminishes proliferation and function of B & T lymphocytes resulting
in decreased inflammation and tissue destruction
also disrupts DNA synthesis via dysregulation of folate
Question:
DMARDs: Considerations when initiating therapy (3)
Answer:
start DMARDs within 3 months of of RA diagnosis alongside NSAID until
therapy becomes effective
pt should be up to date on vaccines prior to initiating therapy
take with folic acid to mitigate GI and Hepatic toxicity
, Question:
Methotrexate adverse effects (4)
Answer:
hepatotoxicity
GI issues
myelosuppression
increased cardiovascular risk
Question:
RA Tx selection
Answer:
Initiate with DMARD and NSAID until DMARD takes effect, then d/c NSAID
Can add additional DMARD
Short term glucocorticoid for flares or until DMARD takes effect