Rheumatoid arthritis Flashcards
Classify drugs used in the treatment of rheumatoid arthritis
- Disease modifying anti-rheumatic drugs
i) non-Biologics
ii) Biologics
a) TNF alpha antagonists
b) IL1 antagonist
c) T cell Modulating agent
d) B lymphocytes depletor - NSAIDs
- Glucocorticoids
Name non biologic drugs
- Methotrexate
- Azathioprine
- cyclophosphamide
- cyclosporine
- Chloroquine
- hydroxychloroquine
- sulphasalazine
- gold salt
- d-penicillamide
- Leflunomide
Name T cell modulating agent
Abatacept
Name B lymphocytes depletor
- Rituximab
- methylprednisolone
What is the mechanism of action of methotrexate
Inhibits chemo taxis of neutrophils and increases production of pro inflammatory cytokines
What are the uses of methotrexate
- Rheumatoid arthritis
- Psoriasis
- Polymyositis
- Giant cell arteritis
- Dermatomyositis
What adverse effects of methotrexate
- Vomiting, Nausea, mucosal ulcer
- hepatotoxicity
What is the mechanism of action of leflunomide
Inhibits dihydrorotate dehydrogenase, thus decreasing pyrimidine synthesis. Inhibits T cell proliferation
What are the best affects of leflunomide
- Diarrhoea
- loss of hair
- liver toxicity
- leukopenia
- Skin rashes
What is the mechanism of action of gold compound
Suppresses cell mediated immunity
What are the adverse effects of gold compounds
- Dermatitis, itching
- stomatitis, mouth ulcers
- proteinuria
- blood dyscrasias
5 hepatitis - peripheral neuropathy
- rarely fatal aplastic anaemia
Name TNF alpha antagonist
- Etanercept
- Infliximab
- Adalimumab
Name IL1 Antagonist used in Rheumatoid arthritis
Anakinra
What are the functions of disease modifying antirheumatic drugs DMARDs 
- Rheumatoid arthritis
- psoriasis
- Crohn’s disease
- ankylosing spondylitis
- scleroderma
