Drugs Used for Treatment of Rheumatoid Arthritis

Question 1

What class of drugs are commonly used in the initial management of RA?

Answer 1

NSAIDs

Question 2

What group of drugs slows disease progression of RA?

Answer 2

DMARDs (disease modifying anti-rheumatic drugs)

Question 3

Why are NSAIDs often taken with DMARDs at the time of initial diagnosis of RA?

Answer 3

because DMARDs can take 2 weeks to 6 months to work?

Question 4

What is the first choice DMARD for treatment of RA?

Answer 4

methotrexate

Question 5

Name some DMARDs to remember.

Answer 5

Hydroxychloroquine, methotrexate, sulfasalazine, glucocorticoids, leflunomide, etanercept, infliximab, adalimumab, anakinra, tofacitinib

Question 6

MOA by which hydroxychloroquine works to treat RA?

Answer 6

stabilizes lysosomes and dec chemotaxis

Question 7

S/E of using hydroxychloroquine

Answer 7

GI distress and visual dysfunction (cinchonism) hemolysis in G6PD deficiency

Question 8

MOA of methotrexate as it pertains to treatment of RA?

Answer 8

cytotoxic to lymphocytes

Question 9

S/E methotrexate?

Answer 9

hematotoxicity, hepatotoxicity

Question 10

Sulfasalazine S/E?

Answer 10

hemolysis in G6PD

Question 11

MOA glucocorticoids that make them well suited to treat RA?

Answer 11

dec LTs, ILs, and platelet activating factor (PAF)

Question 12

S/E of glucocorticoids.

Answer 12

ACTH suppression, cushingoid state, osteoporosis, GI distress, glaucoma

Question 13

MOA leflunomide as it pertains to treatment of RA?

Answer 13

inhibits dihydro-orotic acid dehydrogenase (DHOD) > dec UMP > dec ribonucleotides > arrests lymphocytes in G1

Question 14

S/E of leflunomide?

Answer 14

alopecia, rash, diarrhea, hepatotoxicity

Question 15

What is the MOA of Etanercept as in pertains to treatment of RA?

Answer 15

binds tumor necrosis factor (TNF); is a recombinant form of TNF receptor

Question 16

S/E of etanercept?

Answer 16

infections

Question 17

MOA of Infliximab as it pertains to treatment of RA?

Answer 17

monoclonal ab to TNF

Question 18

MOA of adalimumab as it pertains to treatment of RA?

Answer 18

monoclonal ab to TNF

Question 19

MOA anakinra as it pertains to treatment of RA?

Answer 19

IL-1 receptor antagonist

Question 20

S/E of anakinra?

Answer 20

infections

Question 21

S/E of infliximab?

Answer 21

infections

Question 22

S/E of adalimumab?

Answer 22

infections

Question 23

MOA of tofacitinib as it pertains to treatment of RA?

Answer 23

janus kinase inhibitor

Question 24

S/E of tofacitinib?

Answer 24

infections, lymphomas

Question 25

Sulfasalazine MOA

Answer 25

Sulfapyridine > dec. B cell functions
5-ASA > possibly inhibits COX