NSAIDs and DMARDs Flashcards
Acetominophen
Reversible COX inhibitor (mostly CNS)
Use as antipyretic, analgesic, but not anti-inflammatory
AE: hepatic necrosis in OD
ASA
Irreversible COX inhibitor decreases TXA2 and PGs
Acts mostly at platelets
AE: gastric ulcers, tinnitus, ARF, interstitial nephritis, GI bleed, Reye syndrome
Celecoxib
Selective COX2 inhibitor decreases inflammation and pain, maintains GI mucosa
Use: RA, OA
AE: thrombosis, sulfa allergy
NSAIDs (ibuprofen, naproxen, indomethacin, ketorolac, diclofenac, meloxicam, piroxicam
Rev. inhib COX1/2 blocks PGs synth
antipyretic, analgesic, anti-inflammatory
Indomethacin to close PDA
AE: interstitial nephritis, ulcer, renal ischemia (dilate aff. art.) aplastic anemia
Methotrexate
Anti-folate DHFR inhibitor
supplement with folate, no in preg.
Use in RA, PA, SLE
Leflunomide
Reversibly inhibits dihydroorotate dehydrogenase
Prevents pyramidine synth, suppresses T cells
RA, PA
AE: diarrhea, HTN, hepatotox., teratogen
Stop 2 yrs before trying to get pregnant
Etanercept
anti-TNF for RA, Juvenile A, PA, Ank. spond.
Give SC Qweek with MTX
Fusion protein to bind TNF before it binds TNF-R
Infliximab
Anti-TNF-MAB
CD, RA
Adalimumab
Anti-TNF-MAB
RA
Golimumab
Anti-TNF-MAB
RA, UC
Certrolizumab
Anti-TNF-MAB
RA
Toclizumab
Anti-IL-6, good if fail anti-TNF
Rituximab
Anti CD20+ Be cells to decrease AI in RA synovitis
give with MTX
AE: can progress to multifocal leukencephalopathy
Abatacept
Inhibits CD80 to 86 to 28 to decrease T cell activation
Use in non-responsive RA and avoid other biologics
Ustekinumab
Blocks IL-23R which usually makes Th1/17
PA
