Term
| What is Rheumatoid Arthritis (RA)? |
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Definition
| Chronic, systemic, autoimmune, inflammatory disorder of unknown origin. |
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Term
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Definition
| Cigarette smoking; bacterial or viral invasion; age 30-40 but can occur at any age; In younger people, women 3x more likely than men to get RA; After 60, women=men. |
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Term
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Definition
| Symmetric polyarticular pain and swelling; warmth, tenderness of small joints (wrists, hands, feet, ankles) and other joints (cervical spine, shoulder, elbows, hips, knees); morning stiffness that lasts from 1-many hours; fatigue. |
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Term
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Definition
| Inflammation and tissue destruction occurs in the rheumatoid synovium. Process may be initiated by an interaction between antigen-presenting cells and CD4 T cells, setting off an inflammatory response. Joint damage results from proliferation of the synovial intimal layer which overgrows, invades and destroys adjacent cartilage and bone. |
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Term
| What causes the joint damage associated with RA? |
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Definition
| Joint damage results from proliferation of the synovial intimal layer which overgrows, invades and destroys adjacent cartilage and bone. |
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Term
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Definition
| Believed to be autoimmune. |
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Term
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Definition
| No single test available, need to take S/S, diagnosis of omission. Presence of rheumatoid factor (RF) does not diagnose the disease since people without the disease can sometimes have RF levels. Presence of anti-CCPs (antibodies) could help differentiate from SLE, others. |
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Term
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Definition
| 1: Relieving symptoms/pain; 2: Maintaining joint function and range of motion; 3: Minimizing systemic involvement; 4: Delaying disease progression. |
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Term
| Nonpharmacological treatment of RA? |
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Definition
| Physical therapy; Exercise; Surgery. |
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Term
| Classes of drugs used to treat RA? |
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Definition
| NSAIDs; Glucocorticoids; DMARDs. |
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Term
| Which of the drug classes used to treat RA deal with the pain only, without effect on disease progression? |
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Definition
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Term
| Which of the drug classes used to treat RA deal both with the pain and the disease progression? |
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Definition
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Term
| Which of the drug classes used to treat RA deals with only the disease progression without short term impact on the pain? |
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Definition
| DMARDs. These can take months to take effect, so they aren't much help with short term pain amelioration. |
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Term
| What are the current treatment guidelines for RA? |
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Definition
| Start a DMARD ASAP, within 3 months of RA diagnosis; Use NSAIDs to control symptoms until DMARD takes effect; Use glucocorticoids (e.g., prednisone, prednisolone) for flares. |
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Term
| What is the basic MoA for the DMARDs? |
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Definition
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Term
| What are some toxicities associated with DMARD use? |
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Definition
| Hepatic fibrosis; Bone marrow suppression; GI ulceration; Pneumonitis. |
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Term
| What are the 2 classes of DMARDs? |
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Definition
| Non-biologic (small molecules made by conventional methods); Biologic (large molecules made by DNA recombinant technology). |
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