Drug classes Flashcards
NSAIDs - examples
Ibuprofen
Naproxen
NSAIDs - definition
Non steroidal anti inflammatory drugs
NSAIDs - use
To control acute pain and reduce inflammation
NSAIDs - side effects
Peptic ulceration
Renal impairment
Increased CV risk
Exacerbation of asthma
Steroids - use
For short periods in small doses
Steroids - function
Suppress inflammation
Suppress the immune system
steroids - routes of administration
Oral
IV
IM
Steroids - mechanism of action
Steroids bind to steroid receptor.
The receptor with bound steroid then binds DNA to affect the transcription of genes
How many steroid receptors are there?
6
Examples of steroid receptors
Glucocorticoid Mineralocorticoid Oestrogen Progestin Androgen Vit D
Steroids - side effects
Weight gain Reduction of osteoblast activity (risk of osteoporosis) Fracture risk Muscle wasting Thin skin Fluid retention Immunosuppression
Steroids - sick day rules
Double steroid use
Never stop taking steroids
If vomiting, give IV steroids
DMARDs - definition
Disease Modifying Anti Rheumatic Drugs
Slow acting and take several weeks to take effect
Should be started within 3 months of symptoms starting
DMARDs - first line
Methotrexate
DMARDs - methotrexate - route of administration
Oral
SC
DMARDs - methotrexate - dosage
Administered once per week
DMARDs - methotrexate - indications
Must be using oral contraception
DMARDs - methotrexate - pregnancy
It is tetatrogenic
Must be stopped 3 months before attempting conception
Must take oral contraception for 3 months after stopping methotrexate to allow adequate wash out
Switch to sulfasalazine instead
DMARDs - methotrexate - side effects
Teratogenic Hypersensitivity pneumonitis Hepato-toxicity Mouth ulcer Rash
DMARDs - second line
Sulfalazine
DMARDs - sulfasalazine - use
Often used in combination with methotrexate
Used instead of methotrexate if patient trying to conceive
DMARDs - sulfasalazine - side effects
Hepatotoxicity
Rash
Decreased sperm count
DMARDs - third line
Hydroxychloroquine
DMARDs - hydroxychloroquine - side effects
Irreversible retinopathy
Biologics - definition
Target the abnormal part of the immune system
Used when DMARDs are not effective
Biologics - examples
Anti-TNF therapy (entanercerpt, adalimumab)
Biologics - anti TNF therapy - side effects
Reactivate latent TB
Increased risk of infection
Increased risk of melanotic skin cancer
