What type of disease is RA?
systemic inflammatory disease
autoimmune disease
What are the symptoms of RA
joint inflammation (BILATERALLY) whole person is sick fatigue general malaise low grade temperature
Pharmacological goals of tx of RA
Provide symptomatic relief
Delay progression of disorder
some of drugs used for tx of RA are also used for
antirejection drugs in organ transplant
and management in IBD
provides rapid, symptomatic relief of inflammation and pain in RA
NSAIDS
steriods
antiinflammatories
provide symptomatic relief of inflammation and pain
glucocorticoids
What are the routes glucocorticoids are administered?
IV, oral or intraarticular (injected into inflammed joint)
Side effects of steriods
immunosupression
Potassium rich diets include
bananas potatoes and apricot
DMARDS stands for
disease modifying anti-Rheumatic drugs
Function of DMARDS
slow joint degeneration
slow progression of disease
Downfalls of DMARDS
take a while to work
very toxic
Which is cheaper DMARS biologic/nonbiologic
nonbiologic
How do antimalarial drugs work against RA? Example of antimalarial drgu
theyre antiinflammatories
Hydroxycholorquine/Plaquenil
Hydroxycholorquine/Plaquenil SE***
retinal damage/blindness***
DMARDS I- Nonbiologic Include
Rheumatrex Arva Antiinflammatories: - sulfasalazine Antimalarial drugs- hydroxychloroquine/plaquinil tetracyclines
Drug used for IBS, GI discomfort, liver damage, bone marrow supression
Q: which class
Sulfasalazine
non-major biologic DMARDS-1
What is the drug of choice for RA?
rhumatrex
how often is rhumatrex given?
once a week
rhumatrex other uses
cancer
psoriasis
other immune diseases
which drug is a folic acid analog
rhumatrex
DMARDS II
Major biologic response modifiers
immune modulators
etanercept/ENBREL function
Q2: what category does it fall under
Q3: route
immunosupressant
DMARDS II
injectable
etanercept/ENBREL function SE**
**local reaction injection issues risk of infection skin reax immunosupressant heart failure blood dyscrasias increases risk of herpes zoster
etanercept/ENBREL class
DMARDS II major biologic
DMARDS III
minor nonbiologic and biologic
Gold salts
penicillamine
Cytotoxic drugs- Imuran
Antirejection drugs
Gold salts comes with a risk of
toxicity rashes stomatitis renal toxicity blood dyscrasias inflamed liver- hepatitis GI disturbances (When you give gold you are killing cells)
Penicillamine SE
can cause bone marrow supression
toxicity
Penicillamine is what type of drug
DMARDS III
penicillamine
Class
NOT an antibiotic
DMARDS III
When you give elemenets that kill cells it is called
elemental pharmacology
Anti rejection drugs SE
come with a risk of infection
hepatotoxicity
nephrotoxicity
hirsuitism
Antirejection drugs are what class
DMARDS III
people who cant tolerate rheumatrex/dont want to take injectable would take
Xeljanx
Xeljanx can be taken with biologic/nonbiologic?
Q2: what other medications
Nonbiological DMARDS
Rheumatrex and Methotrexate.
Xeljanz function
decreases immune response to supress inflammation
Xeljanz cannot be taken with
biologic DMARDS
immunosupressants (cyclosporine and azathioprine)
cytotoxic drug used as chemo
penicilamine
DMARDS III
people who cannot tolerate rhumatrex or methotrexate can use
Xeljanz