Rheumatoid Arthritis & Migraine Flashcards
Stages of Rheumatoid Arthritis
Initiation-nonspecific inflammation
Amplification-T-cell activation
Final stage-Chronic inflammation w/ tissue injury
Classes that treat rheumatoid arthritis
NSAIDS
Glucocorticoids
Disease-Modifying Anti-Rheumatic drugs (DMARDs)
Methotrexate MOA
Synthetic DMARD
Antifolate agent
Inhibits AICAR transformylase
First-line DMARD tx for RA
Leflunomide MOA
Synthetic DMARD
Inhibits ribonucleotide synthesis and causes cell cycle arrest
First agent indicated for symptom improvement and retardation of joint damage
Chloroquine and Hydroxychloroquine
Synthetic DMARD
Anti-malarial agents that also work for RA
Etanercept and Infliximab
Biologic DMARD
anti-TNF agents
Anakinra
Biologic DMARD
IL-1 inhibitor
Phases of a migraine
Premonitory phase/prodrome Aura-changes in visual field Headache-Hours to days Resolution Postdrome-hangover, tiredness
Preventative Therapy for migraines tx of choice
B-Blockers
Propanolol (B1 and B2)
Metoprolol (B1)
Other drugs used for preventative therapy of migraines
Amitriptyline-antidepressant (TCA)
Valproic acid-Anticonvulsant
Topiramate-anticonvulsant
Non-specific tx for acute migraines
Aspirin
NSAIDs
Acetaminophen
Avoid overdose
Tx of acute migraine attacks w/ nausea/vomiting
Anti-emetics
**Metoclopramide
Chlorpromazine
Prochlorperazine
Ergot derivatives, drugs and MOA
Ergot derivatives-Vasoconstriction due to a-adrenergic and 5-HT1d stimulation
Ergotamine
Dihydroergotamine
Ergot derivatives advantages, adverse, disadvantages
adv: effective, cheap
Adverse: GI disturbances
Disadv: variable absoprtion/metabolism
Triptan drugs and MOA
Sumatriptan=>selective 5-HT1D and 5-HT1B receptor agonists
