Rheumatology Drugs Flashcards
List some NSAIDs?
Ibuprofen
Naproxen
Diclofenac
Aspirin
How do NSAIDs work?
They’re COX 1 and/or 2 inhibitors
Inhibit the enzyme COX which is essential in the synthesis of prostaglandins and thromboxane A2 from arachidonic acid
Without these, there’s less inflammation
Who should not be prescribed NSAIDs?
Peptic ulcer, bleeding in stomach
Kidney disease
IBD
Heart failure
IHD and stroke (except for aspirin)
Asthma
Side effects of NSAIDs?
Dyspepsia
Nausea and vomiting
Peptic ulceration
CKD over time
AKI
Photosensitivity
Asthma exacerbations
How do steroids reduce inflammation?
Prevents the synthesis of arachidonic acid
So no production of inflammatory cytokines (prostaglandins, thromboxane)
Name some DMARDs?
Methotrexate Hydroxychloroquine Leflunomide Sulfasalazine Azothioprine Penicillamine
How does methotrexate work?
Folic acid inhibitor
??
Side effects of methotrexate?
Nausea Fatigue Immunosupression, pancytopenia, infections Breakdown of oral mucosa Hepatotoxicity Methotrexate induced pneumonitis
What drug should you give alongside methotrexate?
Folic acid
Side effect of hydroxycholorquine?
What else is this drug used for?
Irreversible retinopathy
Malaria
List the types of biologic drugs available?
In order of whats used for RA
- TNF-a inhibitors: infliximab, adalimumab, etanercept, golimumab
- B cell depletor: rituximab
- IL-1, IL-6 inhibitors: toculizumab (IL6), anakinra (IL1)
- Disruption of T cell function: abatacept
(RANK ligand inhibitor: denosumab)
What’s a side effect of cyclophosphamide?
What’s a rule about its use?
Can affected fertility
You’re only allowed only one cycle
