B3.024 - RA Drugs/Therapy

Question 1

Which drugs come in pill form

Answer 1

Methotrexate
Leflunomide
Hydroxychloroquine
Sulfasalazine
Tofacitinib

Question 2

What drugs should be avoided in pregnancy

Answer 2

Methotrexate
Leflunomide
Tocilizumab
Abatacept
Rutiximab
Tofacitinib

Question 3

What drugs are the cheapest

Answer 3

Methotrexate
Leflunomide
Hydroxychloroquine
Sulfasalazine

Question 4

How does Methotrexate work

Answer 4

Inhibition of dihydrofolate reductase decreasing synthesis of purines and pyrimidines interfering with DNA synthesis, repair cellular replication

Question 5

How does Leflunomide work

Answer 5

Inhibits dihydroorotate dehydrogenase inhibiting pyrimidine synthesis leading to reduction of lymphocytes

Question 6

How does hydroxychloroquine work

Answer 6

Inhibits activity of TLRs, inhibits acidification of lysosomes interfering with antigen processing

Question 7

How does sulfasalazine work

Answer 7

Sulfapyridine is active moiety

Question 8

How does Azathioprine work

Answer 8

Purine synthesis inhibitor

Question 9

What are the TNF inhibitors

Answer 9

Certolizumab
Adalimumab
Infliximab
Golimumab
Etanercept

Question 10

How does Tocilizumab work

Answer 10

Humanized MA targeting IL-6 receptor

Question 11

How does Anakinra work

Answer 11

Antagonist of IL-1 receptor

Question 12

How doe Abatacept work

Answer 12

Binds CD80/86 on APCs blocking interaction of CD28 between APCs and T cells

Question 13

How does Rutiximab work

Answer 13

MA directed against CD20 antigen on B lymphocytes resulting in depletion of B cells but NOT plasma cells

Question 14

How does Tofacitinib work

Answer 14

Inhibits JAK enzymes preventing cytokine/growth factor mediated gene expression

Question 15

What is the typical approach to therapy

Answer 15

1. Methotrexate
   2a. Sulfasalazine + Hydroxychloroquine
   2b. TNF inhibitors
2. Other, abatacept, rutiximab, tocilizumab, anakinra, tofacitinib