LG3.5 Pharmacology for DMARDS – Dr. Wightkin Flashcards
What has the stem name “-mab”?
Monoclonal antibody
What has the stem name “-cept”?
Fusion protein
What is the stem name “-nib”?
Kinase inhibitor
What does DMARDS?
Disease-modifying Anti-Rheumatic Drugs
What is the goal of DMARDS?
Therapy with DMARDS should be initiated with the goals of preventing or controlling joint damage, preventing loss of function, and decreasing pain.
What is the MOI of Biological DMARD’s?
Target is TNF-alpha
What is the function of TNF-alpha?
Activates leukocytes, endothelial cells, and synovial fibroblasts, including production of cytokinesm chemokines, adhesion molecules, and matrix enzymes, suppression of regulatory T-cell function, activation of osteoclasts, and respiration of cartilage and bone, mediates metabolic and cognitive dysfunction.
What is the function of monoclonal antibodies?
binds to ligand or receptor
What is the function of fusion proteins?
Binds ligand or false receptor
What are fusion proteins?
Are proteins created through the joining of two or more genes that originally coded for separated proteins
What is the function of kinase inhibitors?
A protein kinase inhibitor is a type of enzyme inhibitor that blocks the action of one or more protein kinases. Protein kinases are enzymes that add a phosphate group to a protein or other organic molecule. Phosphate groups can turn a protein off.
What are concerns of the use of Biological DMARDs?
- Increased risk for tuberculosis and fungal infections.
- Can cause lymphoma in young patients.
What are the two conventional DMARD’s?
Methotrexate and Leflunomide
What is the MOI of Methotrexate?
- Dihydrofolate reductase
- Given IV
- Inhibits DNA and RNA synthesis, increases adenosine levels.
- Decreases intracellular tetrahydrofolate
What is the MOI of Leflunomide?
- Active form is teriflunomide.
- inhibits pyrimidine nucleotides
- Specific for lymphocytes
What are the adverse effects of Methotrexate?
GI intolerance, cirrhosis, bone marrow intolerance
What are the adverse effects of Leflunomide?
Teratogen, Women have to eliminate with cholestyramine, which binds to bile
What endemic Phoenix area fungal infection should be screened for prior to giving a patient with rheumatoid arthritis an inhibitor of tumor necrosis factor? A) Mycobacterium tuberculosis B) Candida albicans C) Histoplasma capsulatum D) Coccidioides immitis E) Giardia lamblia
D) Coccidioides immitis
What drug is NOT a DMARD? A) Ibuprofen B) Methotrexate C) Leflunomide D) Infliximab E) Etanercept
A) Ibuprofen
This drug inhibits the action of dihydrofolate reductase?
A) leflunomide B) methotrexate C) rituximab D) naproxen E) prednisone
B) Methotrexate
What type of drug would Kalousekomab be?
Monoclonal antibody
What type of drug would Mcqueenacept be?
Fusion protein
What type of drug would Wightkininib be?
Kinase inhibitor
