DMARDs Flashcards
What are DMARDs and why are they used with NSAIDs
Disease modifying antirheumatic Drugs
They are used with NSAIDs because it they 2 weeks to work.
What drug is both a DMARD and antimalarial?
Quinolones
Mechanism of Quinolones?
Reduce T-cell activation and chemotaxis
When are Quinolones used?
For patients who no longer respond to NSAIDs or can’t tolerate other DMARDs
What is a side effect of Quinolone?
Retinal damage(chloroquine)
Benefit of glucocorticoid in comparison to other DMARDs? What other drug is like this?
Fast acting can become effective before other drugs.
Acute monoarticular gout
Sulfasalazine(inhibitor of TNF and IL-1)
Mechanism of glucocorticoids?
Inhibits phospholipase A2(inhibits formation of TXA2)
Inhibits COX2 induction
Possible side effect of glucocortioids
Cushingoid symptoms
What is the gold standard for rheumatoid arthritis treatment?
Methotrexate
Inhibits AICAR and causes immunosuppression
What are the mechanism of leflunomide?
DHODH inhibits T-lymphocyte response to stimuli
Why is Etanercept unique?
Blocks binding to TNF to TNF receptor. The -cept stands for receptor .
What are the antibodies that bind to TNF?
CAGIE Certolizumab Adalimumab Golimumab Infliximab Etanercept
Which antibody binds to IL-1?
Anakinra = Anak1nra
Which antibody binds to IL-6?
Toclizumab = To6zumab
Which antibody binds to B-cells?
Rituximab -> binds anti-CD20 mAb, reduces circulating B cells.
Which Drugs(biologic response modifier) are used for RA refractory to TNF-alpha inhibitors?
Rituximab
Abatacept(also refractory to MTX)
What is the action of abatacept?
Inhibits T cell activation and induces T cell apoptosis
Which drugs are used to treat tophaceous gout?
FAPP Febuxostat Allopurinol Probenecid Pegloticase
How does probenecid work?
Inhibit urate reabsorption in renal tubule
How does allopurinol work?
- Reduces uric acid synthesis by inhibiting xanthine oxidase(competitive inhibition) –> alloxanthine
- Alloxanthine is a non-competitive inhibitor of xanthine oxidase
How does febuxostat work?
Non-purine, non-competitive antagonist of xanthine oxidase.
How does probenecid affect other drugs?
Secretion of some weak acids(e.g. penicillin) is reduced
When do you colchicine?
Acute gouty arthritis
How does colchicine?
Prevents tubulin polymerization & leads to inhibition of leukocyte migration(looks like chediak-higashi)
What is one of the side effect of colchicine
Abdominal pain & diarrhea
How does Pegloticase work?
Converts uric acid to ALLANTOIN
