Arthritis Drugs Flashcards
Effect of NSAIDS…
Antipyretic = inhibit PG action on hypothalamus. Analgesic = reduce neutron sensitivity to bradykinin, effective against muscular/skeletal pain. Anti-inflammatory = reduce vasodilation and decrease venule permeability.
Examples of NSAIDS…
Aspirin - rapidly absorbed in stomach, displaces warfarin bound to plasma proteins which causes anticoagulant activity.
Paracetamol - analgesic/antipyretic, suppressing PG production and stimulate serotonergic pathway.
Side effects of NSAIDs…
gastric ulcers, impaired coagulation, GI bleeding, CV events, induce asthma/angiodema/urticarial/rhinitis, kidney damage.
Alternatives to NSAIDS…
Misoprostol - synthetic PG given with NSAID to preserve mucous GI lining and ulceration.
Side effect; diarrhoea, vaginal bleeding.
What are DMARDS…
Drugs with unrelated structures and different mechanisms of action.
Examples of DMARDS…
Methotraxane = folic acid antagonist, inhibit DNA synth, inhibit T cell activation. Sulfasalazine = scavenge free radicals produced by neutrophils. Penicillamine = decrease IL1 generation and fibroblast profile to reduce immune response.
Side effects of DMARDS…
blood dycrasias, liver cirrhosis, folate deficiency, GI upset, headache, skin reactions, leukopenia, rash, stomatitis, anorexia, taste disturbance, fever.
Examples of Gold Compounds…
Auranofin oral = inhibit |IL1 TNFA production to reduce pain/swelling.
Sodium Auranofin inject= concentrates in synovial/liver cells, kidney tubules, adrenal cortex and macrophages.
Side effects of Gold Compounds…
rash, flu, mouth ulcer, blood disorder, encephalopathy, peripheral neuropathy, hepatitis.
Antimalarials…
Chloroquine / Hydrochloroquine.
Increase pH of intracellular vacuoles to induce apoptosis in T-lymph.
Examples of Biological agents…
Anticytokine - surgery.
Adalimumab/Etenercept - inhibit TNFA.
Rituximab- block CD20 on B cells increasing NKC destruction.
Abataceot - prevent activation B cells interfere with APCs.
Toclizumab - block IL6R disrupting immune signals.
JAK inhibitor = oral DMARD
Ofactinub = improve pain, fatigue, soc-emot functioning.
Side effects of Biological agents…
Latent disease: TB, Hep B, opportunistic infection, Nausea, abode pain, heart failure and hypersensitivity.
Examples of immunosuppressants…
Cyclosporin = potent, no effect on acute inflame. inhibit IL2 gene transcription and decrease T cell. Azathioprine = interfere with purine metabolism to decrease DNA synthesis. suppress bone marrow. Leflunomide = inhibit pyrimidine synthesis and T cells. Cyclophosphamide = inhibit DNA cross linking.
Side effects of immunosuppressants…
Nephrotoxicity, hepatotoxicity, hypertension, nausea, gym hypertrophy, GI problems, diarrhoea, alopecia.
