Rheumatoid and Gout Flashcards

1
Q

Indomethicin

Mech
Tx
Side eff

A

NSAID- reduce pain and inflammation

Tx: RA and gout symptoms

Gastric and duodenal ulcers

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2
Q

Naproxen (aleve)

Mech
Tx
Side eff

A

NSAID- reduce pain and inflammation

Tx: RA and gout symptoms

Gastric and duodenal ulcers

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3
Q

COX-2 Inhibitors

Mech
Tx
Side eff

A

Selective NSAID (asprin)

Tx: RA and gout symptoms

Fewer Gastric and duodenal ulcers than indomethicin and naproxen

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4
Q

Qinolones (Hydroxydcholoroquine)

Mech
Tx
Side eff

A

(Hyroxycholoroquine)

DMARD
Reduces T-Cell activation and chemotaxis

Tx: RA and SLE

Retinal damage, Hemolysis in G6PD defficient Pts

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5
Q

Glucocorticoids

Mech
Tx
Side eff

A
  • Inhibit phospoholipase A2 (inhibition of Arachadonic acid release and thus, prostaglandin formation)
  • Inhibit cytokine production (prevents COX-2 induction)

Tx: RA, Gout

Cushingoid symtoms

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6
Q

Sulfasalazine

Mech
Tx
Side eff

A

inhibit IL-1 and TNF-a release

Tx: RA

skin rashes and neutropenia

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7
Q

Methotrexate

Mech
Tx
Side eff

A

DMARD
(ChemoTheraputic Folate analog)

Inhibits AICAR transformylase and thymidilate synthetase, 2* effects on PMN chemotaxis
Causes adenosine accumulation, which inhibits inflammation

Tx: RA

Nausea, stomatitis, hepatotoxicity

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8
Q

Leflunomide

Mech
Tx
Side eff

A

DMARD

inhibits DHODH –> impaired T-cell response to stimuli

Tx: RA

diarrhea, heptotoxic

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9
Q

Etanercept

Mech
Tx
Side eff

A

Biologic response modifier

TNF-a receptors bound by Fc of Ig bind TNF-a
Blocks TNF-a Binding to TNF Receptors

Tx: RA

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10
Q

Infliximab

Mech
Tx
Side eff

A

Biologic response modifier

MAb against TNF-a
Blocks TNF-a Binding to TNF Receptors

Tx: RA

Ag response to Murine Ab

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11
Q

Adalimumab

Mech
Tx
Side eff

A

Biologic response modifier

human MAb against TNF-a
Blocks TNF-a Binding to TNF Receptors

Tx: RA

Not antiogenic like infliximab

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12
Q

Golimumab

Mech
Tx
Side eff

A

Biologic response modifier

Human MAb vs TNF-a
Blocks TNF-a Binding to TNF Receptors

Tx: RA

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13
Q

Certolizumab

Mech
Tx
Side eff

A

Biologic response modifier
Conjugated to PEG for increased T 1/2

Blocks TNF-a Binding to TNF Receptors

Tx: RA

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14
Q

Anakinra

Mech
Tx
Side eff

A

IL-1 Receptor antagonist

Tx: RA

short half life, daily high dose Tx
Infections

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15
Q

Tocilizumab

Mech
Tx
Side eff

A

IL-6 receptor

Tx: RA

Infections

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16
Q

Rituximab

Mech
Tx
Side eff

A

Anti-CD20 Mab

Reduces circulating B-cells

Tx: RA refractory to TNF-a inhibitors

infections, hypersensitivity rxns

17
Q

Abatercept

Mech
Tx
Side eff

A

Inhibits T-cell activation
Induces T-cell apoptosis

Tx: RA refractory to TNF-a inhibitors

Infections and headaches

18
Q

Colchicine

Mech
Tx
Side eff

A

Inhibits microtubule depolymerization, thus inhibiting leukocyte migration, phagocytosis, and cytokine release (like vinca alkyloids vincristine and vinblastine)

Tx: pain and inflammation of acute gouty arthritis

diarrhea due to inhibited epitheilial cell proliferation
perihperal neuropathy
Low Theraputic Index

19
Q

Probenecid

Mech
Tx
Side eff

A

increases excretion of urate in the proximal tubule

Tx: Chronic gout

inhibits excretion of weak acid drugs (eg penicillin)

20
Q

Allopurinol

Mech
Tx
Side eff

A

Suicide inhibitor of Xanthine Oxidase
–> inhibition of purine synthesis

Tx: Chronic Gout

prevents hydrolysis of 6-MP, increasing T1/2

21
Q

Febuxostat

Mech
Tx
Side eff

A

Non-purin, non-competitive XO inhibitor

Tx: Chronic Gout

Nausea, rash, arthralgias
Expensive

22
Q

Pegloticase

Mech
Tx
Side eff

A

stabilized uricase

converts uric acid to allantoin

Tx: Chronic gout