Drug treatment in rheumatology Flashcards
What are DMARDs mainly used to treat?
Rheumatoid arthritis
SLE
Psoriatic arthritis
Vasculitis
What are the 3 most commonly used DMARDs for inflammatory arthritis?/
Methotrexate
Hydroxychoroquine
Sulfasalazine
What DMARDs are teratogenic + should be avoided in pregnancy + breast feeding?
Methotrexate
Leflunomide
Cyclophosphamide
What is the mechanism of action of methotrexate?
Interferes with folate metabolism + suppresses immune system
**ADD MORE INFO
What are the adverse effects of methotrexate?
- nausea
- mouth ulcers + mucositis
- teratogenic
- bone marrow suppression
- hepatitis + cirrhosis
- leukopenia
What is the mechanism of action of hydroxychloroquine?
Suppresses the immune system by:
- interfering with toll-like receptors
- disrupting antigen presentation
- increased pH in lysosome of immune cells
What are the adverse effects of hydroxychloroquine?
- GI disturbances
- retinal toxicity
- hair lightening
- blue/grey skin pigmentation
What is the mechanism of action of leflunomide?
Suppresses the immune system by interfering with the production of pyrimidine
What are the adverse effects of leflunomide?
- GI upset
- hypertension
- hepatitis
- bone marrow suppression
- teratogenic
- mouth ulcers
What is the mechanism of action of sulfasalazine?
What are the adverse effects of sulfasalazine?
- GI upset
- rash
- hepatitis
- orange urine
- bone marrow suppression
- reversible male infertility
What are biological drugs?
Drugs that are designed to impact on the immune system
Mainly monoclonal antibodies
Types of biological drugs + example
- TNF-a inhibitors - etanercept + infliximab
- CD-20 inhibitor - rituximab
- IL-6 inhibitors - tocilizumab
- IL-17 antagonists
- JAK inhibitors upadacitnib
What are adverse effects for biological drugs?
- immunosuppression > risk of infection
- reactivation of hep B + TP risk
