Dexamethasone
analog of cortisol anti-inflammatory and immunosuppressant super potent bacterial meningitis RA
Prednisone
prodrug–> activated in liver
Betamethasone
cortisol analog
topical
Methotreaxate (MTX)
DMARD- small molecule
RA, Crohns, Lupus
immunosuppressive effect (suppresses T cell activation and B cell proliferation)
Leflunomide (ARAVA)
DMARD- small molecule
blocks proliferation of activated lymphocytes
serious side effects on Liver
Infliximab (REMICADE)
TNF DMARD
binds to both soluble and membrane-bound TNF alpha
induces apoptosis of lymphocytes
used in RA, Crohns, and AS
given in combination with Methatrexate
Etanercept (Enbrel)
TNF DMARD
binds soluble TNF
fusion protein (human)
treat RA, Crohns, AS
Adalimumab (HUMIRA)
TNF DMARD binds soluble TNF (acts like sponge) monoclonal antibody down regulates macrophage and T cell function RA and Crohn's
Tocilizumab
biologic DMARD
monoclonal antibody against IL-6 receptor
used if TNFs are not tolerated
Anakinra (KINERET)
biologic DMARD
monoclonal antibody against IL-1 receptor
used if TNF don’t work
Tofacitinib (Xeljanz)
DMARD
RA treatment when Methotrexate doesn’t work
Blocks JAK/STAT pathway
ORAL PILLS
usual side effects
Abatacept
biologic DMARD
inhibit T cells by interfering with CD80 and CD28
Eculizumab
humanized monoclonal antibody that blocks C5 from being cleaved–> prevents MAC
patients are going to be at risk for encapsulated bacterial infections such as Neisseria