DMARDS

Question 1

Indications for the use of methotrexate?

Answer 1

Immunosuppression and dance chemotherapy

Question 2

MOA methotrexate

Answer 2

Methotrexate is an antifolate which antagonises Dihydrofolate reductase. This inhibits purine and thymidine synthesis, inhibiting DNA synthesis.

Question 3

Methotrexate ADRs

Answer 3

Mucositis, myelosuppression, hepatitis and cirrhosis, increased infection risk and teratogenic

Question 4

DDIs methotrexate

Answer 4

Any drugs that affect renal blood flow and renal elimination, e.g NSAIDs

Question 5

Indications for use of Sulfasalazine?

Answer 5

Rheumatoid arthritis and IBD

Question 6

MOA of sulfasalazine?

Answer 6

Metabolised to active component 5ASA. Inhibition of T cell proliferation and IL2 production. Reduced chemotaxis and degranulation.

Question 7

ADRs of sulfasalazine?

Answer 7

Myelosuppression, hepatitis, rash and gi disturbances

Question 8

Contraindications of sulfasalazine?

Answer 8

Renal impairment and hypersensitivity

Question 9

What class of drug does sulfasalazine belong to?

Answer 9

Aminosalicylates

Question 10

Examples of Anti-TNF agents?

Answer 10

Infliximab, rituximab, adalimumab

Question 11

MOA anti-TNF alpha agents

Answer 11

Blocks TNF alpha, decreases inflammation, decreases angiogenesis, decreases joint destruction

Question 12

ADRs of anti TNF alpha drugs

Answer 12

Increased infections, tiredness, dizziness, itching and GI disturbance.