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unit 2 pharm > RA > Flashcards

Flashcards in RA Deck (16)
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1
Q

NSAIDs

A
  • indomethacin, naproxen, COX2 inhibitors
  • eliminate pain and some inflammation but they don’t slow disease progression
2
Q

Glucocorticoids

A
  • DMARD
  • inhibit PLA2 –> inhibits release of AA and formation of PGs
  • inhibit production of cytokines –> prevents induction of COX2
  • long-term use= hyperglycemia, osteoporosis, poor wound healing
3
Q

Gold Salts

A
  • DMARD
  • repress immune responsiveness by inhibiting macrophages
  • rarely used today
4
Q

antimalarials (chloroquine)

A
  • DMARD
  • less efficacious than other DMARDs
  • can cause irreversible retinal damage
5
Q

Sulfasalazine

A
  • DMARD
  • inhibits IL-1 and TNF-alpha
  • acts quicker than other drugs
  • adverse side effects: N and V, headaches, skin rashes, neutropenia (30% of PTS discontinue)
6
Q

Methotrexate

A
  • DMARD (immunosuppressive)
  • “gold standard” for DMARD tx
    1. Inhibition of aminoimidazolecarboxamide(AICAR) transformylase and thymidylate synthetase, with secondary effects on PMN chemotaxis
    1. Causes adenosine accumulation, which inhibits inflammation
7
Q

Leflunomide

A
  • DMARD (immunosuppressive)
  • inhibits DHODH (rate-limiting enzyme requred for de novo synthesis of pyrimidine (UMP) –> inhibition of T cell response
  • oral prodrug
8
Q

Etanercept

A
  • Biological response modifier
  • TNF-alpha antagonist
  • twice weekly subcutaneous injections
9
Q

Infliximab

A
  • biological response modifier
  • TNF alpha antagonist
  • chimeric –> production of antimouse Abs!

**think infliximab inflicts the most pain (bc of antimouse Abs)

10
Q

Adalimumab

A
  • biological response modifier
  • TNF-alpha antagonist
  • fully human Ab–> not antigenic
  • as efficacious as etanercept but more convenient dosing (twice-monthly SQ injections)

**think aladin- magical

11
Q

Golimumab

A
  • biological response modifier
  • TNF-alpha antagonist
  • human MAb that binds membrane-bound and soluble TNFalpha
  • once monthly dosing but side effects (increased risk of infections like TB, fungal and opportunistic pathogens)
12
Q

Certolizumab

A
  • bioglical response modifier
  • TNF alpha antagonist
  • humanized MAb conjugated to polyethylene glycol to delay metabolism
13
Q

Anakinra

A
  • biological response modifier
  • IL-1 receptor antagonist
  • ** think Anak1nra
  • short t1/2 –> frequent daily dosing
14
Q

Tocilizumab (Actemra)

A
  • biological response modifier
  • IL6 receptor antagonist
  • **think Tocilizuma6
  • risk for serious infections
15
Q

Abatacept (Orencia)

A
  • biological response modifier
  • co-stimulation modulator
  • inhibits T cell activation and induces T cell apoptosis

Think A and T –> AbaTacepT= T-cell Activation, Apoptosis

16
Q

Rituximab

A
  • biological response modifier
  • co-stimulator modulator
  • anti-CD20 mAb that reduces circulating B cells
  • approved for RA refractory to TNF-alpha inhibitors