DMARDS Flashcards
Infliximab (Remicade)
- chimeric monoclonal antibody against tumor necrosis factor (TNF)-alpha
- combined with methotrexate
MOA of Adalimumab (Humira)
-
human monoclonal antibody against TNF-alpha
- 100% human peptide sequences
MOA Etanercept (Enbrel)
- fusion protein that is a decoy TNF-alpha receptor so TNF-alpha will bind to it and decrease pro-inflammatory effect
MOA Abatacept (Orencia)
- fully human fusion protein that acts to Inhibit B-cell differentiation and T-cell activation
Rituximab (Rituxan) MOA
- chimeric monoclonal antibody that binds to CD20 and Inhibits B-cell differentiation and T-cell activation
Leflunomide (Arava)
- Inhibitor of dihydro-orotate dehydrogenase
- inhibits pyrimidine (nucleic acid)
- inhibits the induction of COX-2
Micophenolate Mofetil (Cellcept)
- Inhibitors of nucleic acid synthesis
- inhibits lymphocyte purine synthesis
MOA Anakinra (Kineret)
- Interleukin-1 receptor antagonist (IL-1Ra)
Tofacitinib (Xeljanz)
- Janus kinase inhibitors (JAKs)
- JAK 1 and JAK 3
source of TNF-alpha? primary effects?
- source: macrophages
- primary effects: prostaglandin production
- big player in chronic inflammation
MOA of Aurothioglucose
- Inhibit phagocytosis
- Uncouple oxidative phosphorylation and inhibit cellular respiration
- React with proteins
- Suppress cellular immunity
- No analgesic effect
toxicity of Aurothioglucose causes
- bone marrow damage
- enterocolitis
Use of Penicillamine
- chelating drug
- rheumatoid arthritis
- wilson’s disease
toxicites of Penicillamine
- incidence of adverse reactions high
- affects bone marrow
use of Hydroxychloroquine (plaquenil)
- rheumatoid arthritis
- toxicity high
MOA and use of Sulfasalazine (Azulfidine)
- prodrug metabolizes into salicylate and sulfonamide
- inhibit COX1 and COX2
- treat rheumatoid arthritis and crohn’s disease
toxicities of Sulfasalazine (Azulfidine)
- have toxicities of both sulfa drugs and ASA
- GI disturbances
- rash
- hepatitis
route of administraton of Infliximab (Remicade)
IV
adverse reactions of drugs against inflammatory response
- prone to infection and malignancy
contraindications to all of the drugs that affect the inflammatory response
- pregnancy
- breast feeding
- children
- infections
Certrolizumab pegol (Cimiza)
Agents acting on TNF-alpha
Golimumab (Simponi)
Agent acting on TNF-alpha
route of administration of Leflunomide (Arava)
oral
route of administration of Micophenolate Mofetil (Cellcept)
- oral or IV
MOA of Tocilizumab
- monoclonal antibody that competes with IL-6 for binding of IL-6 receptor
