Musculoskeletal System

Question 1

Antifolate antiproliferative

Answer 1

Methotrexate

MoA:
Inhibition of dihydrofolate reductase and DNA synthesis for lymphocyte proliferation

Indication:
Rheumatoid arthritis

Adverse Effects/Interactions:
Nausea, hair loss
Warfarin, corticosteroids

Question 2

Antimetabolite immunosuppressant

Answer 2

Azathioprine

MoA:
Unclear – possible inhibition of DNA synthesis and lymphocyte proliferation

Indication:
Rheumatoid arthritis (also Crohn’s Disease)

Adverse Effects/Interactions:
Alopecia

Question 3

Cytokine modulators

Answer 3

Adalimumab, Etanercept, Infliximab

MoA:
TNF-alpha blockade

Indication:
Rheumatoid arthritis

Adverse Effects/Interactions:
Infections

Question 4

Aminosalicylates

Answer 4

Sulfasalazine, Mesalazine

MoA:
Unclear – possible COX inhibition. Possible free radical scavenging, T cell suppression

Indication:
Rheumatoid arthritis (also Crohn’s Disease)

Adverse Effects/Interactions:
Nausea
Digoxin, warfarin