DMARDs Flashcards
gold salts MOA (4)
suppress cellular immunity by: inhibiting phagocytosis inhibiting proteolytic enzymes inhibiting cellular resp. by uncoupling oxidative phosphorylation preventing PG synthesis
penicillamine (cuprimine) MOA & usage (2)
chelating drug
Wilson’s & RA
penicillamine (Cuprimine) adverse rxns (4)
agranulocytosis/aplastic anemia
proteinuria
nephrotic syndrome
lupus
Hydroxychloroquine (Plaquenil) receptor properties (3)
antihistamine
anticholinesterase
antiprotease
Hydroxychloroquine (Plaquenil) MOA (4)
decreases PG synthesis, mucopolysaccharides
decreased response to chemotactic stimuli & phagocytosis
stabilizes lysosomes
reacts w/ nucleic acids & tissue proteins
Hydroxychloroquine (Plaquenil) SE (5)
pruritis hemolysis (G6PD deficient) ototoxicity retinopathy neuropathy
Sulfasalazine use (2)
IBD
RA
Sulfasalazine SE & cautions
SE: GI, rash, etc
monitor for hepatitis and bone marrow problems during the first 3 mo. of treatment
infliximab (Remicade) MOA (1) & use (3)
monoclonal Ab targeting TNFa
Crohn’s
RA
combined w/ MTX, given IV
Infliximab (Remicade) SE (2)
HA
reactions at infusion site
Infliximab (Remicade) contraindications (4)
pregnancy
breastfeeding
children
infections
Adalimumab (Humira) MOA (2) & use (2)
IgG1 monoclonal Ab for TNFa
has 100% human peptide sequences
monotherapy for RA
subQ
Adalimumab (Humira) SE (4)
rash
flu-like sx
fatigue
HA
Etanercept (Enbrel) MOA and dose
TNF inhibitor
subQ
Etanercept (Enbrel) SE (3)
injection site rxn
infections
increased incidence of Ab fxn
Etanercept (Enbrel) contraindications (5)
bone marrow suppression breastfeeding children diabetes infection
Rituximab (Rituxan) MOA & use
binds to CD20 on B-lymphocytes. CD20 is only expressed on NHL B-cells, not normal
relapsed B-cell NHL, possible CLL
abatacept (Orencia) MOA
blocks T-cell activation
disturbs inflammation & joint destruction in RA
Leflunomide (Arava) MOA (2)
inhibits dihydroorotate DH (DHODH)
inhibits induction of COX-2
Leflunomide (Arava) SE (4)
GI
back pain
oral ulceration
elevated hepatic enzymes
Leflunomide (Arava) contraindications (3)
pregnancy
breast feeding
hepatic/renal failure
Mycophenolate mofetil (Cellcept) MOA
inhibits lymphocyte purine synthesis by inhibiting inosine monophosphate DH (IMPDH)
Mycophenolate mofetil (Cellcept) contraindications (5)
active GI disease diarrhea pregnancy breast feeding infections
Anakinra (Kineret) MOA and use
IL-1 receptor antagonist
RA: improvement of swollen/painful joints within 4-13 weeks
