Flashcards in DMARDS - Treatment of Rheumatoid Arthritis Deck (19):
Firstline therapy for rheumatoid arthritis
Methotrexate (maybe with NSAID or corticosteroid)
MOA of methotrexate
Inhibition of AICAR transformylase; increased adenosine concentrations
Side effects of MTX
Myelosuppression, Cat X pregnancy, pulmonary toxicity; get CBC, LFT, renal analysis
MOA of sulfasalazine
Inhibitor of prostaglandins and leukotrienes
Side effects of sulfasalazine
Blood dyscasias; get CBC, LFT, renal analysis
MOA of Leflunomide
Inhibits dihydroorotate dehydrogenase (pyrimidine synthesis); cell cycle blocker
Side effects of leflunomide
Bone marrow dysplasia, immunodeficiency, Cat X pregnancy; need CBC, LFT, pregnancy test, serum electrolytes
MOA of hydroxychloroquine
Increase intracellular pH; reduced number of peptide-MHC II complexes
Side effects of hydroxychloroquine
Contraindicated in ocular disease - corneal opacities, keratopathy, retinopathy; CNS toxicity - ototoxicity, seizures; need CBC and opthalmalogic exam
Abatacept, adalimumab, anakinra, certolizumab, etanercept, golimumab, infliximab, rituximab, tocilizumab
Which biologic DMARDS are TNF-alpha inhibitors?
Adalimumab, Certolizumab, etancercept, golimumab, infliximab
Target of rituximab?
CD20 receptor on B cells
MOA of Abatacept
CTLA4 - precents T cell co-stimulation via CD28
Side effects of biologic DMARDS?
Immunosuppression (infections, URTIs, don't give vaccines), increased risk of malignancies
Contraindication of infliximab?
Rare side effect of rituximab?
Avoid pregnancy with this biologic...
Blood dyscrasias in which biologics?
(CART) Certolizumab, Anakinra, Rituximab, Tocilimumab