RA, OA, Gout + OP

Question 1

NSAIDS MOA

Answer 1

• inhibit prostaglandin release by inhibiting COX enzymes that produce them
  -> anti-inflammatory
  -> analgesic
  -> anti-pyretic

Question 2

Methotrexate class + MOA

Answer 2

cDMARDs
-> increase intracellular adenosine levels
- adenosine binds to receptors on immune cells + causes cytokine release
-> creates immune suppression

Question 3

Adalimumab class + MOA

Answer 3

bDMARDs
-> TNFa antagonist
- prevents TNFa from binding to receptor
- therefore decreases production of other inflammatory cytokines

Question 4

Prednisolone class + MOA

Answer 4

Glucocorticoids
-> anti-inflammatory via immune suppression
- increase anti-inflammatory cytokines
- decrease pro-inflammatory cytokines
- decrease immune cell activation

Question 5

Allopurinol class, active form + MOA

Answer 5

Xanthine oxidase inhibitor (oxypurinol)
- inhibits effects of xanthine oxidase
- prevents urate forming
- decreases uric acid levels in blood

Question 6

Risedronate class + MOA

Answer 6

Bisphosphonates
- deposited in bone
- osteoclasts resorb bone + internalise drug
- decreases osteoclast function + causes apoptosis
- therefore decrease bone loss / increase BMD

Question 7

Denosumab class + MOA

Answer 7

RANK-L inhibitor
- decreases osteoclast synthesis + formation
- therefore decrease bone resorption + increase BMD

Question 8

Romosozumab class + MOA

Answer 8

Anti-sclerostin antibody
- inhibit synthesis of sclerosin in osteocytes
- therefore prevent osteoblast inhibition by sclerosin
- therefore increase osteoblast activity so increase BMD