Drug Topics - March 2009 - (Page 48) Continuing Education TE ST QU E S TIO NS Write your answers on the form appearing on page 49 (photocopies of the answer form are acceptable) or on a separate sheet of paper. Mark the most appropriate answer. 1. a. b. c. d. 2. a. b. c. d. 3. Which statement about the epidemiology of RA is true? Approximately 5 percent of the adult population has RA. Caucasians have the highest risk of developing RA. Men are more likely than women to develop RA. RA usually presents between the ages of 30 and 60, with an increased incidence through age 85. An example of an antibody produced by the B cells as part of the in ammatory process of RA is: Interleukin-1 Metalloproteinase Rheumatoid factor Tumor necrosis factor-alpha 11. If a patient develops hepatitis B while receiving treatment with in iximab, what should happen with in iximab therapy? a. Close monitoring is warranted with a subsequent dose decrease in in iximab. b. Close monitoring is warranted with a subsequent dose increase in in iximab. c. Continuation of in iximab should occur with initiation of antiviral therapy. d. Discontinuation of in iximab should occur with initiation of antiviral therapy. 12. Combination therapy with methotrexate is necessary for patients treated with in iximab because there is a risk of: a. Development of anticyclic citrullinated peptide antibodies. b. Development of human antichimeric antibodies. c. Worsening of heart failure. d. Worsening of RA symptoms. 13. Rituximab is classi ed as a: a. CD20-directed chimeric monoclonal antibody b. Human recombinant IL-1 receptor antagonist c. Selective T cell costimulation modulator d. TNF-alpha antagonist 14. Patients receiving rituximab may minimize the risk of infusion reaction by premedicating with all of the following except: a. Acetaminophen b. Antihistamine c. Intravenous glucocorticoid d. Metoclopramide 15. How often is it appropriate to give anakinra to patients who have a creatinine clearance of < 30 mL/min? a. Once daily b. Once every other day c. Once weekly d. Once monthly 16. The doctor decides to start a 33-year-old white female on etanercept for treatment of RA. This patient is 5’6” and weighs 70 kg. What dose and frequency of etanercept should this patient receive? a. 25 mg SC twice weekly b. 40 mg SC every other week c. 100 mg SC daily d. 210 mg IV at weeks 0,2,6, and then every 8 weeks 17. Which patient below would be considered the safest candidate for treatment with adalimumab? a. A 37-year-old woman with HIV who is recovering from PCP pneumonia. b. A 42-year-old woman with gastroesophageal re ux disease (GERD). c. A 43-year-old man with a history of epilepsy. d. A 68-year-old man with dyslipidemia, type II diabetes, hypertension, and heart failure. 18. All of the following are boxed warnings associated with rituximab except: a. Fatal infusion reactions b. New onset/worsening of demyelinating disorders c. Severe mucotaneous reactions d. Tumor lysis syndrome 19. All of the following are appropriate administration sites for anakinra except: a. Abdomen b. Side of thigh c. Upper arm d. Upper, outer areas of buttocks 20. The highly in amed, highly erosive exudate that develops and expands to cause cartilage and joint destruction in patients with RA is known as: a. Pannus b. Rheumatoid nodule c. Synovium d. Tumor necrosis factor-alpha W W W.D R U GTO P I C S .C O M Examples of extra-articular manifestations associated with RA include all of the following except: a. Interstitial lung disease b. Rheumatoid nodules c. Tendonitis d. Vasculitis Which of the following is not considered a component of the ACR diagnostic criteria for RA? Elevated CRP and ESR levels Positive rheumatoid factor level Radiographical changes consistent with RA (e.g., bony erosions, loss of bone density) Symmetrical joint involvement Which biologic agent used for RA requires weight-based dosing? Abatacept Adalimumab Anakinra Rituximab Which combination of agents below may be given together safely? Anakinra and etanercept Abatacept and adalimumab In iximab and anakinra Rituximab and methotrexate Which biologic agent has a special warning about increased risk for respiratory symptoms in patients with COPD? Abatacept Anakinra Etanercept In iximab Which biologic agent is given by intravenous infusion? Adalimumab Anakinra Etanercept In iximab Karen suffers from RA and was recently prescribed treatment with etanercept. Which of the following is NOT an appropriate counseling point for her? A PPD tuberculin skin test should be placed before therapy to assess for tuberculosis. Ensure all live vaccinations have been given prior to treatment with etanercept. Hand-washing and avoidance of people who are ill can help lower the risk for infection. Infusion reactions such as urticaria and hypotension may occur, especially after the rst infusion. Which biologic agent is classi ed as an IL-1 receptor antagonist? Abatacept Anakinra Etanercept In iximab DRUG TOPICS 4. a. b. c. d. 5. a. b. c. d. 6. a. b. c. d. 7. a. b. c. d. 8. a. b. c. d. 9. a. b. c. d. 10. a. b. c. d. 48 March 2009 http://WWW.DRUGTOPICS.COM
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