cDMARDS

Question 1

Name CS – DMARDs – classical synthetic

Answer 1

Methotrexate, sulfasalazine, hydroxychloroquine, leflunomide, azathioprine

Question 2

name B-DMARDs – biologic

Answer 2

Etanercept, adalimumab, golimumab, abatacept, rituximab

Question 3

name Ts-DMARDS-targeted

Answer 3

Tofacitinib, baricitinib

Question 4

what to be careful with in cDMARD prescribing

Answer 4

• chicken pox

Question 5

how does methotrexate work

Answer 5

Methotrexate is an anti-folate medication
Interferes with folate metabolism
Growing cells are highly dependent on reduced folates for DNA replication (even more so is rapidly diving cells).
Competitively inhibits dihydrofolate reductase

Question 6

contraception and methotrexate

Answer 6

• contraceptive needed during and for 6 months after cessation

Question 7

sulfasalazine MOA

Answer 7

prodrug - 5-aminosalicylic acid (5-ASA) and sulfapyridine.
Sulfapyridine is the active moiety in RA
5-ASA is thought to be the active form in IBD.

Question 8

counselling of sulfasalazine

Answer 8

signs of infection,
may discolour urine (orange) or contact lenses
G6PD deficiency (susceptible to developing acute haemolytic anaemia)