P3 PHARMACOLOGY Flashcards
not yet completed
Rheumatoid arthritis DOC
methotrexate
why would you use glucocorticoids
- reduce pain
- reduce swelling
- ## slow structural damage progression
what would you use to relieve pain & suppress the inflammation
NSAIDS
what would you use to prevent or control joint destruction
DMADRS
NSAIDS that have less Gi safety profile
Non-selective NSAIDS
NSAIDS that are associated with CV thrombotic events
Selective NSAID
Selective NSAIDS contraindications
coronary artery disease
by-pass graft surgery
types of DMARDS
- conventional
- Biological
- targeted synthetic
Examples of selective NSAIDS
- ibuprofen
- diclofenac
- naproxen
- indomethacin
Examples of non- selective NSAIDS
celecoxib , etoricoxib
, valdecoxib
non- selective NSAIDS are co-prescribed with
PPI / H2 blockers
give at least 4 ADR OF NSAIDS
- headache
- asthma
- rashes
- renal failure
- bleeding
- abdominal pain
- dysplasia of GIT
- GIT ulcer
- fluid retention
- HTN
- edmea
- CHF
subtypes of bDMARDs
- TNf -alpha blocker
- Non -TNF-alpha blocker
MTX anti-inflammatory effects are mediated by
Accumulation of adenosine
MTX ADR can be reduced by
leucovorin
MTX side effects
Pulmonary fibrosis ,,,, does related hepatotoxicity
MOA of MTX
Inhibition of dihydrofolate reductase leading to decreased dTMP that leads to decreased DNA synthesis
MOA of bDMARDS
binds to TNF-alpha in ECF»_space; neutralises it
mention the 2 IL-6 blockers
sarilumab
tocilizumab
Targeted synthetic DMARDs MOA
JAK inhibitors
MOA OF Rituximab
B-cell depleting cytotoxic agent
ADR of hydroxychloroquine
ocular toxicity
MTX ADR
myelosuppression, hepatic toxicity , pulmonary infiltrate
ADR OF tofacitinib ( JAK Inhibitor )
INFECTIONS
dyslipidemia
DOC IN DMARD naive patients with low disease activity
hydroxychloroquine
DOC IN DMARD naive patients with moderate to severe disease activity
MTX
MOA OF abatacept
Inhibitors of T-cell activation by binding to CD80/CD86 thereby blocking CD28 interaction
