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Year 2 Revision > Rheumatoid Pharmacology > Flashcards

Rheumatoid Pharmacology Flashcards

1
Q

What are the common features of DMARDs?

A 
Slow acting
Anti-inflammatory not analgesic
Improve lab tests for inflammation
Reduce rate of joint damage
Regular monitoring for adverse effects required
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2
Q

What is the mechanism of action of methotrexate?

A

Unknown (folate antagonist).

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3
Q

What are the routes of administration for methotrexate?

A

Oral or SC.

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4
Q

What are the diseases methotrexate may be used in?

A

Psoriatic arthritis, RA, connective tissue disease, vasculitis.

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5
Q

What are the adverse effects of methotrexate?

A

Leucopenia/thrombocytopenia, pneumonitis, hepatitis/cirrhosis, nausea and diarrhoea, rash/mouth ulcers.
FBC and LFT monitoring required!

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6
Q

How long does methotrexate need to be stopped for before conception?

A

At least 3 months.

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7
Q

What is the mechanism of action for leflunomide?

A

Inhibits enzyme, resulting in decreased reproduction of rapidly dividing cells e.g. white blood cells.

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8
Q

What is more effective, methotrexate or leflunomide?

A

Equal efficacy.

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9
Q

What are the side effects of leflunomide?

A

Similar to methotrexate.

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10
Q

What is a downside to using leflunomide?

A

Very long half-life requiring washout.

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11
Q

What DMARDs would you use in pregnancy?

A

Sulfasalazine and hydroxychloroquine.

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12
Q

What are the adverse effects of sulfasalazine?

A 
Nausea
Rash/mouth ulcers
Neutropenia
Hepatitis
Reversible oligozoospermia
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13
Q

What is hydroxychloroquine commonly used in?

A

Connective tissue disease.

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14
Q

What is the main adverse effect of hydroxycholoroquine?

A

Retinopathy.

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15
Q

Name 2 other DMARDs.

A

Sodium aurothiomalate (gold) and penicillamine.

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16
Q

How are penicillamine and sodium aurothiomalate administered?

A

Penicillamine - orally.

Sodium autothiomalate - IM.

17
Q

What are the side effects of sodium aurothiomalate and penicillamine?

A

Bone marrow suppression
Glomerulonephritis
Rash
Mouth ulcers

18
Q

What has anti-TNF therapy been licensed in?

A

RA, psoriatic arthritis, ankylosing spondylitis.

19
Q

How effective is anti-TNF therapy in comparison to DMARDs?

A

1.5x

20
Q

What are the adverse effects of anti-TNF therapy?

A

Risk of infection esp TB
May cause malignancy esp skin cancer
Contraindicated in pulmonary fibrosis and heart failure

21
Q

Name 2 xanthine oxidase inhibitors.

A

Allopurinol and febuxostat.

22
Q

What are the adverse effects of allopurinol?

A

Vasculitis rash
Reacts with azathioprine
Marrow aplasia

23
Q

What is the adverse effect of febuxostat?

A

Renal impairment

24
Q

What drugs cause gout?

A

Diuretics, anti-hypertensives, aspirin (basically all involved in kidney function somehow).

Year 2 Revision (45 decks)

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