25 - A) RHEUMATOID ARTHRITIS Flashcards
TYPES OF DRUGS THAT CAN BE USED
- Analgesic and anti-inflammatory
- NSAID
- Corticoids - DMRAD (Disease- modifying drugs): need longer periods to be effective.
- Classic, low molecular weigth.
- Biological agents.
NSAID
ANALGESIC AND ANTI-INFLAMMATORY DRUGS (Al igual que los corticoids).
They are rarely used alone as they do not inhibit the evolution of the disease; they are combined with opioids; ibuprofen + hydrocodone or ibuprofen + oxycodone.
We can also use naproxen.
If symptoms are more severe, higher doses can be used of; celecoxib, ibuprofen, naproxen and piroxicam.
They should not be administeresconcurrently of after high-dose methotrexate. They reduce the clearance of methotrexate, resulting in higher and prolonged plasma levels.
CORTICOIDS
They are immunosupressant and anti-inflammatory drugs.
Prednisone, prednisolone, methylprednisolone, triamcinolone and dexamethasone, all of them p.o.
METHOTREXATE CHARACTERISTICS
DMRAD; CLASSICS
Antimetabolite (folic acid analogue); inhibitor of dihydrofolate reductase, it interferes with DNA reducing the purine and pyrimidine supply in rapidly dividing cells. Before as chemotherapy treatment.
Lower uses; useful for RA. Once per week as a pill or iv. It may be comined with other DMARDs or with a biological agent.
Upset stomatch and sore mouth. No during preganancy.
It can interfere with the bone marro’w production of blood cells. Liver or lung damage can occur.
AZATHIOPRIINE
It is used in patients who have not responded to other tratmnts. It is gven po 1-4 times daily.
CYCLOSPORINE
It’s an antibiotic originally developed to prevent rejection after organ transplantation. It works in patients twith RA to inhibit T lymphocytes.
SULFASALAZINE
A
HYDROXYCHLOROQUINE
B
LEFLUNOMIDE
C
DMRAD; BIOLOGICAL AGENTS
D
