DMARDs Flashcards
What does DMARD stand for, and what is its purpose?
DMARD stands for Disease Modifying Anti-Rheumatic Drugs. They are used to control symptoms and slow or stop the progression of diseases like Rheumatoid Arthritis and other chronic inflammatory diseases.
What is Rheumatoid Arthritis, and how does it affect the body?
Rheumatoid Arthritis is a common chronic inflammatory autoimmune disease where the immune system attacks healthy cells, leading to persistent inflammation, mostly in the joints. It can cause the affected joints to become swollen, painful, deformed, and immobile. It affects 1 in 100 people and is a major cause of disability.
How do NSAIDs and corticosteroids differ from DMARDs in treating Rheumatoid Arthritis?
NSAIDs and corticosteroids are mainly used for symptom control or relief, whereas DMARDs not only help control symptoms but also slow the progression of the disease, making them more effective in treating Rheumatoid Arthritis and improving patients’ quality of life.
What are Conventional Synthetic DMARDs (csDMARDs), and give an example?
Conventional Synthetic DMARDs are small synthetic molecules. Methotrexate is the most commonly used csDMARD. It was originally developed to treat cancer but was found effective for treating Rheumatoid Arthritis in the 1980s and was approved for use in 1988.
What is the mechanism of action of Methotrexate?
Methotrexate was initially designed to inhibit the enzyme dihydrofolate reductase, involved in folate metabolism, which helps in cancer treatment by inhibiting the growth of unwanted cells. It may also have anti-inflammatory effects by inhibiting the enzyme AICAR transformylase, leading to increased adenosine, which reduces inflammation.
Why do Conventional DMARDs require regular monitoring?
The mechanisms of action of Conventional DMARDs are non-specific, which can lead to serious side effects. Therefore, regular monitoring is required to manage potential risks.
What are Biological DMARDs, and why are they considered a breakthrough in treatment?
Biological DMARDs are biopharmaceuticals derived from living organisms, usually proteins. They represent a major breakthrough because they are highly specific in their mechanism of action and have shown high efficacy, especially in cases where Conventional DMARDs have not been effective.
How do Biological DMARDs differ from Conventional Drugs in terms of manufacturing?
Biological DMARDs are highly complex and difficult to replicate due to their biological origin, while Conventional Drugs are easier to replicate through chemical synthesis.
What are the key mechanisms of action for Biological DMARDs?
Biological DMARDs work through:
Cytokine inhibition: Reducing key pro-inflammatory cytokines.
B-cell depletion: Targeting CD20 on B-cells, leading to cell death or depletion.
Inhibition of T-cell activation: Preventing T-cell activation by inhibiting the second signal required for their activation.
What are the advantages and disadvantages of Biological DMARDs?
Advantages: Specific mechanism of action, high efficacy in symptom relief, and ability to slow or stop disease progression.
Disadvantages: Require IV or subcutaneous injection, increase susceptibility to infection and malignancy, complex and difficult to manufacture, unstable requiring proper storage, and are expensive.
How does Rheumatoid Arthritis contribute to disability?
Rheumatoid Arthritis affects 1 in 100 people and causes persistent inflammation in the joints, which can lead to joint damage, swelling, pain, deformity, and immobility, making it a common cause of disability.
What is the main reason for the slow onset of action of Conventional DMARDs?
Conventional DMARDs take several months to show effects because their mechanisms of action are non-specific and can have serious side effects, requiring careful monitoring.
What is the connection between Methotrexate and folate metabolism?
Methotrexate was designed to inhibit dihydrofolate reductase, an enzyme involved in folate metabolism. This inhibition can help in cancer treatment by preventing the growth of unwanted cells.
What are the potential risks associated with Biological DMARDs?
Biological DMARDs increase susceptibility to infections, pose a higher risk of malignancy, and are sensitive to storage conditions. They are also expensive.
Why are Biological DMARDs considered more stable than Conventional DMARDs?
Biological DMARDs are large protein molecules that are more unstable and sensitive to external conditions, requiring careful storage, unlike the smaller molecules in Conventional DMARDs which are more stable.
What does the term “biopharmaceutical” mean in the context of Biological DMARDs?
Biopharmaceutical refers to medicinal products derived from living organisms. In the case of Biological DMARDs, they are usually large protein molecules that are complex to manufacture and difficult to replicate.
How does inhibition of T-cell activation contribute to the effectiveness of Biological DMARDs?
Inhibiting the second signal required for T-cell activation prevents co-stimulation, blocking the activation of T-cells that contribute to inflammation in conditions like Rheumatoid Arthritis.
What are the main differences in the manufacturing process between Biological DMARDs and Conventional Drugs?
Biological DMARDs are derived from living organisms and have a complex, difficult-to-replicate manufacturing process. Conventional Drugs, on the other hand, are small molecules that are easier to replicate through chemical synthesis.
