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Pharm 2
Immunosuppressant/Immunomodulator Therapy
| Question | Answer |
|---|---|
| Which disease-modifying antirheumatic drug (DMARD) is beneficial in rheumatoid arthritis (RA) by inhibiting the enzyme Janus kinase? | Tofacitinib |
| Which disease-modifying antirheumatic drug (DMARD) requires a “washout” if it needs to be quickly removed from the body? | Leflunomide |
| Which disease-modifying antirheumatic drug (DMARD) may be given orally, subcutaneously, or intramuscularly? | Methotrexate |
| Which disease-modifying antirheumatic drug’s (DMARD’s) metabolism occurs through CYP3A4 and is subject to drug interactions involving this isoenzyme? | Tofacitinib |
| A nurse is caring for a patient diagnosed with rheumatoid arthritis (RA) who has been prescribed leflunomide 100 mg PO daily for 3 days then 10 mg PO daily. Before the patient begins leflunomide, which baseline parameters would the nurse assess? | -Blood cell counts -Blood pressure -Liver function tests -Purified protein derivative (PPD) test |
| Which patients diagnosed with rheumatoid arthritis (RA) would a nurse determine can safely receive therapy with methotrexate? | -A 49-year-old patient with hypertension -A 56-year-old patient with dyslipidemia |
| A nurse is caring for a patient with rheumatoid arthritis (RA) who is prescribed leflunomide. The patient is currently taking metformin and pioglitazone for type 2 diabetes, lisinopril for hypertension, and simvastatin for dyslipidemia. | -- |
| Which drug is expected to interact with leflunomide? | Pioglitazone |
| A patient who was diagnosed with rheumatoid arthritis (RA) 7 years ago is currently managed with weekly oral methotrexate, hydroxychloroquine taken twice daily, and etanercept 50 mg SC weekly. | -- |
| The patient is currently experiencing a worsening of RA symptoms and has tried numerous tumor necrosis factor (TNF)-α antagonists with minimal success. | -- |
| The rheumatologist decides to start abatacept 125 mg SC weekly after a loading dose and discontinue therapy with etanercept. Which instructions would a nurse include when teaching a patient about the administration of the newly prescribed abatacept? | -“Inject abatacept into the abdomen, thighs, or upper arm.” -“Rotate injection sites, avoiding areas that are bruised, hard, or red.” -“You may experience changes in blood pressure, injection site reactions, headaches, and dizziness with abatacept.” |
| Which patient would a nurse determine cannot safely receive therapy with leflunomide? | A 49-year-old patient with end-stage liver disease |
| A nurse is caring for a patient prescribed tofacitinib extended-release 11 mg PO daily who is also receiving methotrexate, HCTZ, and ethinyl estradiol/levonorgestrel. Which teaching point would the nurse provide to the patient about administration? | It cannot be crushed or chewed. |
| A patient with rheumatoid arthritis (RA) asks the nurse why he or she was told to take folic acid with methotrexate. Which rationale would the nurse provide? | To reduce gastrointestinal and hepatic toxicity |
| A nurse is caring for a patient with rheumatoid arthritis who has been prescribed abatacept. Which drug-drug product can be safely administered to a patient who is receiving abatacept? | Methotrexate |
| T-cell costimulation modulator | Abatacept |
| Tumor necrosis factor (TNF)-α antagonist | Etanercept |
| Dihydroorotate dehydrogenase inhibitor | Leflunomide |
| Janus kinase inhibitor | Baricitinib |
Created by:
Lightnning54
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