D-Penicillamine Flashcards
What is penicillamine?
a characteristic degradation product of penicillin used as a DMARD for rheumatoid arthritis and chelating agent in Wilson’s disease.
What are other drugs in the same class as penicillamine?
leflunomide
methotrexate
sulfasalazine
What is the mechanism of action of penicillamine?
suppresses disease activity by lowering IgM rheumatoid factor.
depresses T cell activity (but not B cell activity)
what are the indications of penicillamine?
DMARD
chelating agent
lead poisoning
enhancement of urinary heavy metal excretion
What is the role of penicillamine in RA therapy?
for severe active RA of which other DMARDs have failed
What are the precautions associated with penicillamine?
hypersensitivity to penicillin monitor xray FBC including differentials to be conducted LFTs for toxicity, allergy, mucous membrane reactions menstruating women should have Fe supplmenetation Pregnancy class D avoid lactation children
What are the contraindications with penicillamine?
concomitant gold therapy
antimalarials
what are the adverse reactions of penicillamine?
hypersensitivity drug fever fe deficiency elevated ESR myasthenia gravis hepatic dysfunction GI upset allopoecia impaired taste
