anti-RA drugs Flashcards
1. Describe the limitations to the use of non-steroidal anti-inflammatory drugs in the treatment of rheumatoid arthritis. 2. Explain why the use of corticosteroids is controversial in the treatment of rheumatoid arthritis. 3. List the prototype “synthetic” disease modifying anti-rheumatic drugs, describe their mechanism of action and clinical uses, and list their major adverse effects. 4. List the prototype “biologic” disease modifying anti-rheumatic drugs, describe their mechanism of action
problem with using NSAIDS for RA
do not prevent the irreversable damage to the joints
problems with using corticosteroids for RA
too many side effects with long term use
current use of steroids in RA
bridge therapy until long-term drugs kick in
synthetic RA DMARDs
methotrexate, hydrocychloriquine, sulfalazine, lefunomide, gold salts
biological RA DMARDS
TNF inhibitors, IL-1 inhibitors, IL-6 inhinitors, B/T cell inhibitors
SE of methotrexte
hepatotox
SE of sulfasalazine
hepatotox
SE of antimalarial drugs
retinopathy
MOA of methotrexate
antimetaboliite (inhibits DHF)
MOA of sulfasalazine
anti-inflammatory and antimicrobial
MOA f cyclosporin
T-cell avtivation inhibitor
SE of cyclosporin
kidney tox
use of sulfasalzine
RA, juvinile chronic arthritis, ankylosing spondy
typically added to pts taking methotrexate
leflunomide
may increase hypertension
leflunomide
TNF inhibors
etanercept, xxx-mab (NOT tocilizumab/rituximab)
increases risk of infection, ESPECIALLY TB
TNF inhibitors
can cause MS-like illness
TNF inhibitors
black box warning about cancer risk
TNF inhibitors
must screen for TB before using
TNF inhibitors
chimeric human/mouse monoclonal anti0TNF anibody
infliximab
T/B cell inhibitors
anakinra, tocilizumab, abatacept, , rituximab, tofiacitnib,
anti IL-6 drug
tocilizumab
used when other DMARBs fail
tocilizumab, rituximab
