Disease-modifying Anti-rheumatic Drugs

Question 1

DMARD/cancer chemotherapeutic/thymidilate synthetase inhibitor used as FIRST CHOICE to treat RA, also used in SLE, JRA, ankylosing spondylitis, dermatomyositis, Wegener’s granulomatosis, etc.

Answer 1

Methotrexate

Rescue agent: Leucovorin (Folinic acid)

Question 2

DMARD, TNF-a activator used in Crohn’s dse, RA, etc.

AE: REACTIVATION OF TB, URTIs, lymphoma, etc.

Answer 2

Infliximab

synergistic with methotrexate

Question 3

DMARD used for RA, psoriatic arthritis, SLE, Behcet’s dse

AE: bone marrow suppression

Answer 3

Azathioprine

CANNOT be used with ALLOPURINOL -> severe leukopenia

Question 4

DMARD/antimalarial drug used in RA, SLE, SJOGREN’S SYNDROME and MALARIA which suppresses T-lymphocyte responses and leukocyte chemotaxis

AE: Ocular toxicity

Answer 4

Chloroquine

SimD: Hydroxychloroquine

SAFE for PREGNANT women

Question 5

DMARD/cancer chemotherapeutic drug used for RA, SLE, vasculitis, Wegener’s granulomatosis with know AE of HEMORRHAGIC CYSTITIS

Answer 5

Cyclophosphamide

Rescue agent: MESNA

Question 6

DMARD/IL1 and IL2 inhibitor used for RA, SLE, Wegener’s granulomatosis, dermatomyositis, polymyositis, JRA, TISSUE TRANSPLANTATION

AE: Gingival Hyperplasia, Hirsutism

Answer 6

Cyclosporine

Question 7

DMARD/IMP dehydrogenase inhibitor used in SLE nephritis, vasculitis, RA, Wegener’s granulomatosis

AE: Reversible myelosuppression (NEUTROPENIA)

Answer 7

Mycophenolate mofetil

Active product: mycophenolic acid

Question 8

DMARD used in IBD, JRA, RA, ankylosing spondylitis which may cause HEMOLYTIC ANEMIA, METHEMOGLOBINEMIA, antiDSNA FORMATION, REVERSIBLE INFERTILITY FOR MEN, neutropenia and thrombocytopenia

Answer 8

Sulfasalazine

Active product: Sulfapyridine