Q@Q time ④ - cardio69

[ArchivalUser]

A 44 y/o F presents to you with increasing morning stiffness and pain in her hands and fingers. She has severe tenderness over her proximal interphalangeal joints and has had difficulty using her hand due to pain. She has severe swan neck deformities and boutonniere of her hands. The woman also notes that she has had difficulty breathing and pain when she takes deep breath. Pat lab reveals neutrophil and lymphocyte within norm range and Hgb 9.8 g/dL. Pat fails to respond past 5mons triple therapy. You decide to add 4th drug that metabolite primarily CYP3A4 and ↓ IL-21 & 7 production on your pat.

Which of the following correctly represents the MOA of 4th drug ( soon may help fight hair loss along with like i.e ruxolitinib) added?

a) TNF alfa inhibitor
b) Inhibitor of Jk
c) Ininhitor IL-6 R
d) Dihydrofolate reductase inhibitor

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[ArchivalUser]

etanercept

[ArchivalUser]

Ans *B*
Tofacitinib" -> JAK1/JAK2/ IL-6 & TNF JAK1/JAK3*/ T & B cell signal
JAK3* blockage => DEC IL-2,4,7,9,15, & 21. that can fit our pat, bz Hgb conc more than 9 g/dL to
start tofacitinib.

From what I been also given and what I been ask. Intersting http://www.thestandarddaily.com/ruxoliti...owth/6856/


@usmle, Etanercept is a recombinant that more like TNF inhibitor & lymphotoxin alfa.