Anti-Arthritic Drugs

Question 1

Anti-Arthritic Drugs types?

Answer 1

1. Osteoarthritis treatment
2. Gout Anti-inflammatory drugs
3. Gout Anti-­hyperuricemic drugs
4. Rheumatoid Arthritis Management Drugs

Question 2

Osteoarthritis treatment?

Answer 2

1. Pain relief:
   NSAIDs (or paracetamol, coxib)
   Corticosteroids
2. Viscosupplementation:
   Intra-­articular hyaluronic acid
3. Symptomatic slow-­acting drugs:
   Chrondroitin
   Glucosamine

Question 3

Gout Anti-inflammatory drugs?

Answer 3

1. NSAIDs
2. Corticosteroids
3. Colchicine

Question 4

Colchicine USES?

Answer 4

Rapid relief of pain and inflammation

Question 5

Colchicine mechanism?

Answer 5

• Binds to tubulin and prevents polymerization to microtubules
• Inhibit replication and proliferation of leukocytes and reduces phagocytotic activity

Question 6

Colchicine Side Effects & Contraindications?

Answer 6

• GIT disturbances

* Hepatotoxity

Question 7

Gout Anti-­hyperuricemic drugs types?

Answer 7

1. Xanthine Oxidase Inhibitors

2. Uricosuric Agents

Question 8

Xanthine Oxidase Inhibitor Drugs?

Answer 8

1. Allopurinol

2. Febuxostat

Question 9

Xanthine Oxidase Inhibitor mechanism?

Answer 9

• Inhibits uric acid formation from hypoxanthine and xanthine

Question 10

Xanthine Oxidase Inhibitor Side Effects & Contraindications?

Answer 10

• Allergic reaction
• GIT disturbances
• Peripheral neuritis

Question 11

Uricosuric Agents Drugs?

Answer 11

1. Probenecid

2. Sulfinpyrazole

Question 12

Uricosuric Agents mechanism?

Answer 12

• Inhibits uric acid reabsorption at PT to increase excretion

Question 13

Uricosuric Agents Side Effects & Contraindications?

Answer 13

• GIT disturbance and rashes
• Possible nephrotic syndrome
- Need to give alkali to keep urine above pH 6

Question 14

Rheumatoid Arthritis management drugs?

Answer 14

1. Methotrexate
2. Chloroquine
3. Sulfinsalazine
4. Lefluonomide
5. Anti-TNF

Question 15

Methotrexate Drugs?

Answer 15

Oral / Subcut / IM

Question 16

Methotrexate mechanism?

Answer 16

Inhibition of AICAR transformylase to inhibit immune response by increasing ADP and activation of A2a receptors

Question 17

Methotrexate Side Effects & Contraindications?

Answer 17

• Oral ulcers
• Hepatotoxicity
• Teratogen

Question 18

Chloroquine Drugs?

Answer 18

Chloroquine / Hydrochloroquine

Question 19

Chloroquine mechanism?

Answer 19

Mechanism unknown, reduces inflammation

Question 20

Chloroquine Side Effects & Contraindications?

Answer 20

• Increased oxidative stress
• GIT disturbances
• Alopecia, Rash
• Ocular toxicity

Question 21

Sulfinsalazine Drugs?

Answer 21

Metabolized to active metabolites

Question 22

Sulfinsalazine mechanism?

Answer 22

• Suppresses lymphocytes and cytokine release

* Decrease rheumatoid factor release

Question 23

Sulfinsalazine Side Effects & Contraindications?

Answer 23

• GIT disturbance
• Headache, rash
• Reversible infertility

Question 24

Lefluonomide Drugs?

Answer 24

• Metabolized to active metabolite A77-1726

Question 25

Lefluonomide mechanism?

Answer 25

• Inhibition of dihydroorotate dehydrogenase to decrease pyrimidine synthesis and arrest lymphocyte development

Question 26

Lefluonomide Side Effects & Contraindications?

Answer 26

• Oral ulcers
• Hepatotoxicity
• Teratogen

Question 27

Anti-TNF Drugs?

Answer 27

• Adalimumab
• Infliximab
• Etanercept

Question 28

Anti-TNF mechanism?

Answer 28

• Block signalling to activate other immune cells and therefore suppress local inflammation

Question 29

Anti-TNF Side Effects & Contraindications?

Answer 29

• Immune suppression with increased risk of infection
• Leukopenia, aplastic anemia
• Optic neuritis