Arthritis/ Gout/ Hyper uricemia drugs

Question 1

Ibuprofen

Answer 1

NSAID
-anti inflamm and pyretic
-analgesic
——–
-RA
-mild pain
-head ache
-fever
——–
-GI upset and ulcers
-edema (salt and water retention)
-renal failure from loss of PG protection
-CNS confusion, depression

Question 2

Celecoxib

Answer 2

COX-2 selective NSAID
-anti inflammatory and pyretic
-analgesic
——-
-Pain
-fever
-inflammation
——
-thromboembolism
-CNS, confusion, depression

Question 3

Methotrexate

Answer 3

DMARD
-Folate antagonist preventing DNA
——-
-RA
-Cancer
-Psoriasis
-muscle or vein inflamm
——–
-GI upset
-liver toxicity
-Bone marrow depression

Question 4

Sulfasalzine

Answer 4

DMARD
-salicylic acid moiety releases in colon providing anti inflamm
——-
-RA
-Juvenile arthritis
-IBD
——–
-GI upset
-Headache
-Rash

Question 5

Leflunomide

Answer 5

DMARD
-metabolite inhibits dihydrooratate dehydrogenase preventing T-cell proliferation and B-cell production of antibodies
——
-RA
——–
-25% get diarrhoea
-increased BP
-Weight gain

Question 6

Tofacitinib

Answer 6

targeted synthetic DMARD
-inhibits JAK
———
-RA
-Psoriatic arthritis

Question 7

Apremilast

Answer 7

targeted synthetic DMARD
-inhibits PDE4 and generation of TNF-alpha
——
-psoriatic arthritis

Question 8

Infliximab

Answer 8

biologic DMARD
-inhibits TNF-alpha not allowing it to activate inflamm cells
——-
-second line drug for RA (combo with methotrexate)
-second line for psoriatic arthritis
——-
-GI upset
-headache
-URTI
-Cough from leukotrienes

Question 9

Colchicine

Answer 9

/
Interferes with mitosis in inflammatory cells and increase antiinflammatory mediators
———
-crystal associated arthritis
-gout
———–
-renal failure
-narrow therapeutic index
-bone marrow suppression
-myopathy and neuropathy

Question 10

Probenecid

Answer 10

Uricosuric
-fully absorbed by proximal tubule preventing uric acid reuptake
——–
-Gout
———
-Mild GI upset
-rare allergic reaction
-usually well tolerated

Question 11

Sulfinpyrazone

Answer 11

Uricosuric
-fully absorbed by proximal tubule preventing uric acid reuptake
——–
-Gout
———
-Mild GI upset
-rare allergic reaction
-usually well tolerated

Question 12

Allopurinol

Answer 12

Uricosuric
-xanthine oxidase inhibitor which prevents uric acid synthesis
——-
-Gout
-renal stones
-hyperuricemia
——-
-skin reactions
-stevens johnson syndrome
-liver and renal issues

Question 13

Febuxostat

Answer 13

Uricosuric
-Non purine xanthine oxidase inhibitor which prevents uric acid synthesis
———
-gout
-renal stones
-hyperuricemia
——–
-increase for heart attack, stroke
-less hypersensitivity than allopurinol