Specialty Cert for Pharmacists – Qs And As
TNF Alpha Inhibitors ✔ Ans - Cimzia
Enbrel
Humira
Simponi
Remicade
IL-1 inhibitors ✔ Ans - Kineret
Araclyst
Ilaris
IL-4 Inhibitors ✔ Ans - Dupixent
IL-6 Inhibitors ✔ Ans - Actemra
Kevzara
IL-17a Inhibitors ✔ Ans - Cosentyx
Taltz
Siliq
IL-12/23 Inhibitors ✔ Ans - Stelara
IL-23 Inhibitors ✔ Ans - Tremfya
T-Cell Inhibitors ✔ Ans - Orencia
PDE-4 Inhibitor ✔ Ans - Otezla
JAK Inhibitor ✔ Ans - Xeljanz
Olumiant Rinvok
Integrin Receptor Antagonist ✔ Ans - Entyvio
GLP-2 Analog ✔ Ans - Gattex
Anti-CD20 Monoclonal Antibody ✔ Ans - Rituxan Urate-Oxidase Enzyme ✔ Ans - Krystexxa
WHAT IS DOSE OF CIMZIA FOR CD? ✔ Ans - 400MG SQ @ WEEK 0,2, & 4.
THEN 400MG Q4WKS
Cimzia® (certolizumab pegol) ✔ Ans - 400mg SQ at week 0, 2, and 4, then 400mg q 4 weeks OR 200mg q 2 weeks FOR RA-AS-PSA
HOW CAN I BILL CIMZIA MEDICALLY? ✔ Ans - USE THE CIMZIA VIALS FOR OFFICE USE
CIMZIA STORAGE/USE: ✔ Ans - Refrigerate, bring to room temp, prior to
admin. Protect from light. Reconstituted vials may be retained at room temp < 2 hrs or refrigerated < 24 hrs
WHAT DRUGS ARE IN THE TNF CLASS? ✔ Ans - CHERS DRUGS--CIMZIA, HUMIRA, ENBREL, REMICADE & SIMPONI
WHICH TNF CAN BE USED IN POLYARTICULAR JIA & WHAT DOSE? ✔ Ans
- Enbrel, =>63KG - 50MG/WK & <=62KG 0.8MG/KG/WK
ENBREL DOSAGE (EXCEPT JIA & PLAQUE PSORIASIS): ✔ Ans - 50MG SQ QWK FOR RA, PSA, & ANKLYOSING SPONDYLITIS
ENBREL DOSAGE IN PLAQUE PSORIASIS ✔ Ans - 50MG SQ TWICE A WEEK FOR 3 MONTHS, THEN 50MG QWK
WHICH TNF DRUG FORMS HAVE LATEX? ✔ Ans - HUMIRA PFS, SIMPONI PEN&PFS, ENBREL PEN & PFS (ENBREL VIAL OK) (Humira CF version OK)
WHAT ARE SOME GENERAL COUNSELING POINTS OF TNF INHIBITORS? ✔ Ans - Ongoing LABS: TB at regular intervals, CBC, CMP Q 3 months. S/Sx of malignacy, infection, CHF, TB, malignancy; Avoid live vaccines. May increase CYP450 enzymes = close monitoring of meds with narrow therapeutic index (warfarin, theophylline, CsA) @ initiation or d/c of TNFi Some starting labs before initiating TNF inhibitors: ✔ Ans - Baseline: TB,
HBV, CBC, CMP.
ENBREL STORAGE/USE: ✔ Ans - Refrigerate in original carton. Stable @ room temp for single period of < 14 days. If not used within this period must Be discarded. Warm to room temp prior to use
HUMIRA DOSED AT 40MG SQ EVERY OTHER WEEK FOR THESE DISEASE STATES: ✔ Ans - RA, PSA, AS--NO LOAD!
HUMIRA DOSED AT 80MG SQ WEEK 1 ✔ Ans - 40MG SQ Q OTHER WEEK
STARTING 1 WK AFTER LOAD:, UVEITIS, PLAQ PSOR, and HS
HUMIRA DOSED IN DOSED IN JIA: ✔ Ans - 10-14KG = 10MG QO WK | 15-
29KG = 20MG QO WK | =>30KG = 40MG Q O WK
HUMIRA DOSED IN JIA: ✔ Ans - 10-14KG = 10MG QO WK | 15-29KG = 20MG QO WK | =>30KG = 40MG Q O WK
TNF DRUGS WITH CONCOMMITANT ________ OR _________HAS BEEN ASSOCIATED WITH _____________________ IN YOUNG MALES WITH UC/CD: ✔ Ans - AZOTHIAPRINE/MERCAPTOPURINE --- HEPATOSPLENIC T-CELL LYPHOMA (HSTCL)
WHICH CLASS OF DRUGS HAS BEEN ASSOCIATED WITH MS/LUPUS/CHF? ✔ Ans - TNF INHIBITORS
SUBQ SIMPONI (GOLIMUMAB) DOSAGE IN RA ✔ Ans - AS, & PSA, 50MG SQ Q MONTHLY
IV ARIA (GOLIMUMAB) ✔ Ans - USED ONLY IN RA--2MG/KG WEEK 0,4 THEN Q 8 WKS W/MTX (SAME DRUG AS SIMPONI)
SIMPONI (GOLIMUMAB) FOR UC: ✔ Ans - 200MG SQ WEEK 0 - THEN 100MG SQ WK 2 - THEN 100MG Q 4 WKS
NAME THE 2 TNF'S AVAILABLE AS IV FORMULA: ✔ Ans - REMICADE & ARIA
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