Final Drugs

Question 1

Aspirin

Answer 1

MOA: Cox 1 and 2 suicide inhibitor; inhibits prostaglandins, prostacyclins, and thromboxane

Uses: Low dose inhibits platelet agg.; High dose for fever and anti-inflammitory

Adverse: GI bleeds, rare nephrotoxicity

Question 2

Naproxen

Answer 2

MOA: Cox 1 and 2 reversible inhibitor

Uses: General anti-inflammatory

Adverse: Nephrotoxicity, GI toxicity, MI, and Stroke

Question 3

Celecoxib

Answer 3

MOA: Selective Cox 2 inhibitor

Uses: General anti-inflammatory

Adverse: Nephrotoxicity, GI toxicity, MI, and Stroke

Question 4

Etanercept

Answer 4

MOA: Decoy TNF alpha receptor

Uses: RA, spondyloarthrpathies, JIA, and other autoimmune disorders

Adverse: Increased risk of infections; Injection reaction; unclear malignancy risk

Question 5

Adalimumab

Answer 5

MOA: mAb against TNF alpha

Uses: RA, spondyloarthrpathies, JIA, and other autoimmune disorders

Adverse: Increased risk of infections; Injection reaction; unclear malignancy risk

Question 6

Methotrexate

Answer 6

MOA: Inhibition of enzymes that leads to higher levels of extracellular adenosine and adenosine receptor activation; at high doses cancer treatment via DHFR

Uses: RA and JIA; higher doses cancer

Adverse: Bone marrow depression, teratogenic; increased risk of infection

Question 7

Mycophenolate Mofetil

Answer 7

MOA: Inhibits inosine monophosphate dehydrogenase; depletes cells of guanosine nucleotides

Uses: Transplantation immunosupprosents; SLE nephritis

Adverse: Bone marrow depression; teratogenic; increased infection risk

Question 8

Azathioprine

Answer 8

MOA: Pro-drug metabolized; inhibits nucleotide synthesis and DNA replication; inhibits lymphocyte proliferation

Uses: Used for SLE, vasculitis, other autoimmune diseases

Adverse: Bone marrow depression; teratogenic; increased infection risk

Question 9

Prednisone

Answer 9

MOA: Gluccocorticoid receptor dependent changes in gene expression and cell signaling leading to inhibition of leukotriene and prostaglandin synthesis; inhibition of leukocyte function and alteration in trafficking

Uses: Wide variety including anti-inflammatory and immunosuppression

Adverse: Many when used chronically

Question 10

Rituximab

Answer 10

MOA: mAb that binds CD20 on immature B cells; mediates lysis and clearance of these cells

Uses: ANCA-related vasculitis; somtimes RA, SLE, other autoimmune disease; also used for B-cell lymphoma

Adverse: Anemia and neutropenia; increased risk infection; infusion reaction or serum sickness

Question 11

Cyclosporine

Answer 11

MOA: binds cyclophillin and inhibits calcineurin; prevents NFAT activation and cytokine transcription

Uses: Inhibit rejection in transplant; also used in autoimmune disease

Adverse: Nephrotoxicity; Neurotoxicity; Hypertension

Question 12

Sirolimus

Answer 12

MOA: Binds FKBP-12 and inhibits mTOR; Prevents IL-2 receptor signaling; inhibits T cell proliferation

Uses: Inhibits rejection in transplant

Adverse: Increase triglycerides and cholesterol; bone marrow suppression; hepatotoxicity; increased infection risk

Question 13

Abatecept

Answer 13

MOA: Fusion protein of CTLA4 and IgG; Binds B7 molecules and decreases T-cell activation

Uses: Autoimmune and autoinflammatory conditions

Question 14

Anakinra

Answer 14

MOA: IL-1 receptor that prevents IL-1 activation and downstream signaling

Uses: Treat chronic inflammatory arthritis; certain autoinflammatory diseases

Adverse: Increased risk of infection; Injection site reaction

Question 15

Tocilizumab

Answer 15

MOA: mAb that binds IL-6 receptor preventing activation and downstream signaling

Uses: Autoimmune and auto inflammatory diseases

Adverse: Increased risk of infections; injection site reaction; Neutropenia; Increased cholesterol and lipid abnormalities

Question 16

Tofacitinib

Answer 16

MOA: small molecule that inhibits Janus kinase enzymes involved in intracellular signalling

Uses: RA; Psoriatic arthritis; Ulcerative Colitis

Adverse: Increased risk of infections; Increased cholesterol and lipid abnormalities