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Flashcards in RA Pharm - Fitz Deck (11)
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1

4 drugs classes (besides anti-inflammatories) for RA

Non-specific drug types for RA

- DMARDs
- Anti-TNF-alpha
- Anti-IL1
- JAK inhibitor

- NSAIDs
- Steroids

2

4 DMARD (disease-modifying anti-rheumatic drugs)

- Methotrexate
- Hydroxychloroquine
- Sulfasalazine
- Leflufamide

3

MoA of Leflunamide

Inhibits dihydroorotate dehydrogenase

4

Frontline DMARD of choice for RA

**How does it work (for RA)?

Methotrexate

Slowly becomes polyglutaminated within cells over 25-30 weeks (takes long time to reach steady state), then inhibits AICAR TRANSFORMYLASE. AICAR accumulation leads to ADENOSINE accumulation, which leads to ANTI-INFLAMMATORY effect

5

Methotrexate - major side effect

Should do what else with it?

Hepatotoxicity

Take folic acid or eat foods high in it

6

MoA of glucocorticoids in RA



Adverse effects?

Repress NFkB transcription factor, thus repressing transcription of cytokines secondarily

Osteoporosis, DM

7

Etanercept - MoA

TNF receptor decoy, thus absorbing TNF-alpha

8

Anti-TNF monoclonal antibodies

Infliximab
Adalimumab

9

Anakinra

IL-1 receptor antagonist

10

Anti-TNF agents (3)

All share what?

Etanercept, Infliximab, Adalimumab

Risk of serious opportunistic infections (TB, others)

11

Tofacitinib

JAK inhibitor