Drugs for Rheumatoid arthiritis Flashcards
3 classes of Drugs are used for tx. of Rheumatoid arthritis
NSAIDs
Glucocorticoids
DMARDs: Methotrexate;
Do NSAIDs and corticosteroids prevent disease progression or joint destruction?
what drugs have this abiltiy?
No
DMARDs can prevent disease progression and joint damage. (may take 6wks-6months to become clinically evident)
DMARDs - Disease Modifying Anti-Rheumatic Drugs:
- Non- Biologicals?
- Biologicals?
Non-Biologicals: methotrexate Leflunomide Hydroxychloroquine Sulfasalazine Cyclosporine Azathioprine Cyclophosphamide
Biologicals: “ARA”
Anakinra
Rituximab
Abatacept
Biologicals: Anti TNF drugs “IEA”
- Adalimumab
- Infliximab
- Etanercept
Methotraxate is the first choice for?
First choice to tx. rheumatoid arthritis.
- lower doses than those used in cancer chemo!
Leflunomide
When can it used and how?
same as methotrexate
may be used as combo with methotrexate for patients who are unresponsive to methotrexate.
Hydroxychloroquine
when is the use of the drug least effective, and how toxic is it?
how many months to see benefits?
Moderately effective for mild RA
least toxic of DMARDs
Least effective as monotherapy
3-6 months to show benefits
sulfasalazine
Benefit seen in how long?
Effectiv in RA
2-3 months for benefits
Cyclosporine
What limits its use?
Helpful in some patients with RA
Nephrotoxicity and other interactions limit use.
Azathiopurine
When is it used?
patients w/ refractory RA
Cyclophosphamide
When is it used?
limited to most severe cases of RA.
Long term use increases chances of infection and malignancy.
Anti-TNFa use with methotrexate has what type of effect
Synergistic effect
Ant-TNFa s act faster or slower than Nonbiological DMARDs?
Faster
Rituximab
how is it prescribed?
Commonly given w/ methotrexate or another nonbiologic DMARD
ABATACEPT
when is it used?
effective in some patients who did not respond to nonbiologic DMARDs or anti-TNF agents
ANAKINRA
How effective is it?
Approved for moderate to severe RA
Modestly effective
