DMARDs 1

Question 1

DMARDs (3 groups + 3)

Answer 1

Gold salts
Glucocorticoids
Immunomodulators
Other (Folic acid antagonist, immunosuppressive drug, antimalarial drug)

Question 2

Which glucocorticoid is often used for rheumatoid arthritis?

Answer 2

Prednisone

Question 3

Why are glucocorticoids used as DMARD?

Answer 3

Induce remission while waiting for slower-acting DMARD to work. Short courses during flare-ups

Question 4

DMARD of choice in rheumatoid arthritis

Answer 4

Methotrexate

Question 5

Methotrexate - MOA

Answer 5

Inhibition of human folate reductase.
Inhibition of lymphocyte proliferation & production of cytokines & rheumatoid factor.
Interferes with polymorphonuclear leukocyte chemotaxis, which reduces cytotoxins & free radicals

Question 6

Methotrexate - contraindications

Answer 6

Pregnancy

Question 7

Methotrexate - adverse effects

Answer 7

Hepatic & pulmonary reactions

Question 8

Immunosuppressive drug used as DMARD

Answer 8

Leflunomide

Question 9

Leflunomide - MOA

Answer 9

Inhibits leukocyte & T-cell proliferation by inhibiting pyrimidine synthesis in immune cells

Question 10

Leflunomide - Contraindications

Answer 10

Pregnancy

Question 11

Leflunomide - adverse effects

Answer 11

Reversible alopecia

Question 12

Methotrexate cannot be combined with

Answer 12

Leflunomide

Question 13

Antimalarial drug used as DMARD

Answer 13

Hydroxychloroquine

Question 14

Hydroxychloroquine - adverse effects

Answer 14

Blurred vision
Scotomas
Night blindness

Question 15

Hydroxychloroquine - MOA as DMARD

Answer 15

Reduces chemotaxis and phagocytosis of PMNs, reduced superoxides from these cells