DMARD's Flashcards
What are DMAR’s
Disease-modifying antirheumatic drugs
What are DMARD’s used for and when should they be used?
DMARD’s are used in the treatment of rheumatoid arthritis. They should be used to try and stop or slow the progression of joint destruction and inflammation when NSAID’s have stopped working.
Which DMARD is used at the beginning of therapy?
Methotrexate
What is the mechanism of action of Methotrexate?
Probably related to enzyme inhibition
What are the side effects of Methotrexate?
GI problems with possible nausea and vomiting
What are the adverse effects of Methotrexate?
Hepatic dysfunction, blood dyscrasis (thrombocytopenia and leukocytopenia), acute or chronic non septic pneumonitis/ pulmonary run
Who should not take Methotrexate?
If you’re obese/have a fatty liver, its with decreased renal fxn,
MEthotrexate is an antagonist to what substance?
Folic acid
What drug interactions does methotrexate have?
Medications that inhibit the active tubular secretion of methotrexate, folic acid antagonists
What is the onset of effect for Methotrexate?
Relatively rapid onset, btwn 2-6 wks
What are Anti-TNF-á Drugs?
Anti Tumor Necrosis Factor drugs. Biologics
What is TNF-á?
A cytokine that is directly involved in the inflammation of rheumatoid arthritis
What are some type of Anti-TNF-á drugs?`
Enbril, Remicade, Leflunomide (Arava)
What are some side effects of enbril?
Essentially none.
What are the adverse effects of enbril?
Essentially none although it is contraindicated in patients with sepsis or a severe active infection
