Disease Modifying Anti-Rheumatic Drugs (DMARDS) Flashcards
1
Q
methotrexate
A
- inhibitor of dihydrofolate reductase
- fastest DMARD
- causes adenosine efflux which produces anti-inflammatory effect
- risk of bone marrow suppression, liver fibrosis, ulcers, and fetal death
2
Q
hydroxychloroquine
A
- accumulates in lysosomes and increases the pH
- limits the proper presentation of antigens by changing the interaction with MHC II
- safe to use in pregnancy
- risk of retinal damage
3
Q
sulfasalazine
A
- cleaved to sulfapyridine
- may cause release of adenosine, or inhibition of NF-kB
- risk of GI effects, sulfa rxn
4
Q
leflunomide
A
- inhibits dihydroorotate dehydrogenase to block the production of rUMP
- inhibits T cell proliferation
- risk of GI upset, SJS, pancytopenia
5
Q
etanercept
A
- fusion protein which inhibits TNF
- given subQ 1-2x/week
6
Q
adalimumab
A
- recombinant, fully human mAb that inhibits TNF
- given subQ every 2 weeks
7
Q
infliximab
A
- chimeric mAb which inhibits TNF
- given IV every 6 weeks
8
Q
rituximab
A
- chimeric mAb which prevents the expression of CD20 on B cells
- Ig levels are not changed because plasma cells are not killed
- work better when autoantibodies are detected
- risk of hypersensitivity
9
Q
abatacept
A
- fusion protein that prevents the binding of CD80/CD86 with CTLA-4
- prevents T cell stimulation
- risk of serious infection
10
Q
tocilizumab
A
- humanized antibody
- inhibits IL-6 receptor
- prevents acute phase signaling
- risk of serious infections
11
Q
tofacitinib
A
- JAK3 antagonist
- directly inhibits the production of IL-17 and IFNγ, as well as the proliferation of T cells
- given orally, small molecule
- risk of serious infection, and malignancy
12
Q
anakinra
A
- recombinant human IL-1 receptor antagonist
- blocks the pro-inflammatory activity of IL-1
- risk of serious infection
