Anti rheumatoid arthritis (RA) drugs

Question 1

Methotrexate
1) Methotrexate works by interfering with the metabolism of what?
2) What is prescribed alongside methotrexate?
3) Name 2 side effects

Answer 1

1) Folate
2) Folic acid
3) Mouth ulcers and mucositis, liver toxicity, bone marrow suppression and leukopenia, teratogenic

Question 2

Leflunomide
1) Leflunomide is an immunosuppressant medication that works by interfering with the production of what?
2) This is an important component of what?
3) Name 2 side effects

Answer 2

1) Pyrimidine
2) RNA and DNA
3) Mouth ulcers and mucositis, increased blood pressure, rashes, peripheral neuropathy, liver toxicity, bone marrow suppression and leukopenia, teratogenic

Question 3

Sulfasalzine
1) The mechanism of action of this drug is related to the metabolism of what?
2) Name a side effect

Answer 3

1) Folate
2) Temporary male infertility (reduced sperm count) and bone marrow suppression

Question 4

Hydroxychloroquine
1) This drug is traditionally used for what?
2) It acts as an immunosuppressive medication by interfering with what?
3) How does this cause an immunosuppressive effect?
4) Name 2 side effects

Answer 4

1) Malaria
2) Toll-like receptors
3) Disrupting antigen presentation increases the pH in lysosomes of immune cells
4) Nightmares, liver toxicity, decreased visual acuity, skin pigmentation

Question 5

Anti TNF drugs
1) How do they work
2) Name 2 of them
3) How does etanercept differ from the rest?
4) Name a side effect of these drugs

Answer 5

1) Inhibiting TNF has an anti-inflammatory result
2) Adalimumab, infliximab, golimumab, certolizumab pegol, etanercept
3) Etanercept is a protein that binds TNF to the Fc portion of IgG and thereby reduces its activity, whereas the rest are monoclonal antibodies to TNF
4) Vulnerability to severe infections and sepsis, and reactivation of TB and hepatitis B

Question 6

Rituximab
1) How does it work?
2) Name 2 side effects

Answer 6

1) It’s a monoclonal antibody that targets the CD20 protein on the surface of B cells, causing their destruction
2) Vulnerability to severe infections and sepsis, night sweats, thrombocytopenia, peripheral neuropathy, liver and lung toxicity