Arthritis and Gout Drugs Flashcards
Name the two non-selective NSAIDs and which of the following functions they provide: elimination of pain, slowing of disease progression or reduction of inflammation
Indomethacin and Naprozen; elimination of pain and reduction of inflammation only
What are indomethacin and Naproxen used to treat?
rheumatoid arthritis and gout arthritis
Name the class of selective NSAIDs and the functions they provide.
COX-2 inhibitors; eliminate pain and reduce inflammation
What are COX-2 inhibitors used to treat?
conventional NSAID for RA
What are the 2 common side effects of all NSAIDs?
gastric and duodenal ulcers; COX-2 inhibitors to a lesser extent
Name 6 drugs classified as “disease modifying antirheumatic drugs” (DMARDS).
Gold Salts, Quinolones, glucocorticoids, sulfasalazine, methotrexate and leflunomide
What is the mechanism of action of Gold Salts?
inhibits the functional activity of macrophages to repress immune response
rarely used anymore
What is the mechanism of action of quinolones and what other disease can they be used to treat?
decreases T-Cell activation and chemotaxis; also used for SLE
What is the mechanism of action of Glucocorticoids and what other disease can they be used to treat?
- Inhibits phospholipase A2 (inhibiting release of arachidonic acid and, thus, formation of prostaglandins)
- Inhibits cytokine production (which prevents induction of COX-2)
* *also used for acute gout arthritis**
What is the mechanism of action of Sulfasalazine?
inhibition of IL-1 and TNF-a release
What is the mechanism of action of Methotrexate?
- Inhibition of aminoimidazolecarboxamide (AICAR) transformylase and
thymidylate synthetase, with secondary effects on PMN chemotaxis - Causes adenosine accumulation, which inhibits inflammation
What is the mechanism of action of leflunomide?
Inhibits dihydroorotate dehydrogenase (DHODH), which inhibits T-lymphocyte response to stimuli
What is a severe side effect of using quinolones and when are they used?
retinal damage; used when patients aren’t responding to NSAID’s anymore
What type of symptoms can be a side effect of using glucocorticoids?
cushingoid symptoms
When in the progression of RA are glucocorticoids used and why?
initially after dx because they start working before other drugs
Which two DMARD’s cause GI symptoms and hepatotoxicity?
Methotrexate and Leflunomide
What are some side effects of taking sulfasalazines?
skin rashes, neutropenia, headaches
issues with d/c
Name the class of RA drugs: Etanercept, Infliximab, Adalimumab, Golimumab, Certolizumab, Anakinra, Tocilizumab, Rituximab and Abatacept
Biologic response modifiers
All used to treat RA
Which of the following block response to TNF by inhibiting its interaction with the receptor? Etanercept, Infliximab, Adalimumab, Golimumab, Certolizumab, Anakinra, Tocilizumab, Rituximab and Abatacept
Etanercept, Infliximab, Adalimumab, Golimumab, and Certolizumab
Which of the following is an IL-1 receptor antagonist? Etanercept, Infliximab, Adalimumab, Golimumab, Certolizumab, Anakinra, Tocilizumab, Rituximab and Abatacept
Anakinra
Which of the following is an IL-6 receptor antagonist? Etanercept, Infliximab, Adalimumab, Golimumab, Certolizumab, Anakinra, Tocilizumab, Rituximab and Abatacept
Tocilizumab
Which of the following is a monoclonal Ab that is Anti-CD20 (reduces # of B-cells)? Etanercept, Infliximab, Adalimumab, Golimumab, Certolizumab, Anakinra, Tocilizumab, Rituximab and Abatacept
Rituximab
Which of the following inhibits T-Cell activation and induces T-Cell apoptosis? Etanercept, Infliximab, Adalimumab, Golimumab, Certolizumab, Anakinra, Tocilizumab, Rituximab and Abatacept
Abatacept
Which of the Biologic response modifiers can elicit and antigenic response to murine monoclonal Ab?
Infliximab
Which of the biologic response modifiers are fully human monoclonal Ab?
Adalimumab and Golimumab
Which two of the biologic response modifiers pose a risk to developing serious infections?
Golimumab and Cartolizumab
When is abatacept used and what are the possible side effects?
In patients for RA refractory to MTX or TNF-alpha inhibitors
side effects-headaches, infections
When is Rituximab used and what are the possible side effects?
RA refractory to TNF-a inhibitors
side effects-infections and hypersensitivity reactions
Name 4 drugs used to treat chronic tophaceous gout.
Probenecid, Allopurinol, Febuxostat and Pegloticase
What is the mechanism of action of colchicine and what is it used for?
Prevents tubulin polymerization & inibits leukocyte migration, phagocytosis, and release of cytokines
treats acute gouty arthritis b/c it works in 12-24 hours
What is the mechanism of action of Probenecid?
Inhibits urate reabs. by competing with urate at anionic transport site of renal tubule
Which two drugs inhibit xanthine oxidase causing a decrease in uric acid synthesis?
Allopurinol and Febuxostat (nonpurine)
What is the mechanism of Pegloticase?
converts uric acid to allantoin
Which two drugs used to treat chronic tophaceous gout can actually cause an acute gout attack from urate crystal mobilization?
Probenecid and Allopurinol
What are the side effects of using long term colchicine?
peripheral neuropathy and neutropenia
