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Index
»
PHARMACOLOGY 1
»
CHAPTER 16
»
Level 7 - (DMARDs)
level: Level 7 - (DMARDs)
Questions and Answers List
DISEASE-MODIFYING ANTIRHEUMATIC DRUGS (DMARDs)
level questions: Level 7 - (DMARDs)
Question
Answer
• Used in the treatment of RHEUMATOID ARTHRITIS and have been shown to SLOW THE COURSE OF THE DISEASE, INDUCE REMISSION, and PREVENT FURTHER DESTRUCTION of the joints and involved tissues • Should be started within 3 months from diagnosis
DISEASE-MODIFYING ANTIRHEUMATIC DRUGS (DMARDs)
MOA: a folic acid antagonist that INHIBITS CYTOKINE PRODUCTION and PURINE NUCLEOTIDE BIOSYNTHESIS, leading to immunosuppressive and anti-inflammatory effects (response occurs after 3-6 WEEKS OF Tx) LOW DOSE: DMARDs HIGH DOSE: Anti Cancer A/E: MUCOSAL ULCERATION & nausea, cytopenias (low WBC count), liver cirrhosis, ACUTE PNEUMONIA-LIKE SYNDROME (IN CHRONIC USE)
METHOTREXATE
(folinic acid) given OD after MTX to reduce severity of adverse effects ANTIDOTE for METHOTREXATE TOXICITY
LEUCOVORIN
• Used for early, mild RHEUMATOID ARTHRITIS (often combined with MTX), also for MALARIA AND LUPUS • MOA: (for RA) unknown, onset of effect takes 6 weeks to 6 months • A/E: OCULAR TOXICITIES (irreversible retinal damage, corneal deposits)
HYDROXYCHLOROQUINE
MOA: an immunomodulatory agent that preferentially causes CELL ARREST OF THE AUTOIMMUNE LYMPHOCYTES through its action on DIHYDROOROTATE DEHYDROGENASE (DHODH) – irreversible inhibitor DHODH - ENZYME NEEDED FOR LYMPHOCYTE ACTION
LEFLUNOMIDE
•A tetracycline antibiotic considered to be a DMARD •NOT UTILIZED AS A FIRST-LINE THERAPY but is effective in the treatment of EARLY RHEUMATOID ARTHRITIS
MINOCYCLINE
• MOA: unknown •Also used for EARLY RHEUMATOID ARTHRITIS in combination with MTX or HYDROXYCHLOROQUINE (onset is 1-3 months) •A/E: LEUKOPENIA (Immunosuppressant)
SULFASALAZINE
•PRESCRIPTION DRUG •POTENT ANTI-INFLAMMATORY used for RHEUMATOID ARTHRITIS to provide symptomatic relief and BRIDGE THE TIME until DMARDs are effective
GLUCOCORTICOIDS
