DMARDS-Non-Biological

Question 1

Methotrexate

Answer 1

AICAR transformylase
Immunosupression, lung pneumonitis/fibrosis, CI vaccines, lymphomas, derm. Rx, GI increase with NSAIDS
Cat X
Polyglutination retains MTX in the cell

Question 2

Hydroxychloroquine

Answer 2

Increase pH in vacuoules
Decrease MHC-2 (CD4 + T Cell Response)
Eyes: corneal, keratopathy, retinopathy
CI liver/alcoholism, blood dyscrasia, CNS: neuritis, ototoxic, seizures, neuromyopathy
Eye exam
Malaria/RA/SLE Rx

Question 3

Leflunomide

Answer 3

DHODHi via A77 1726
Liver: CI alcoholism/SCID/bone marrow dysplasia/infection
Cat X

Question 4

Sulfasalazine

Answer 4

PG and LT inhibits
Blood dyscrasia, CI with salicylate and sulfa. Allergy
Colon bacteria activate
Poor acetylators: high lev.