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DMARDs
Disease Modifying Anti-Rheumatic Drugs
12
Pharmacology
Graduate
09/15/2010

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Cards

Term
Hydroxychloroquine
Use
Mechanism
Adverse Effects
Contra
Special
Definition
Mild RA/SLE
Alkalinize Lysosome/Vesicle
Impairs Ag processing/cytokine prod.
GI upset
skin rxns (mild)
AGEP-Acute Gen. Exanthematous Pustulosis
Retinopathy
Pre-existing ocular disease
Min effect on done destruction-weak drug
Term
Leflunomide
Use
Mechanism
Adverse Effects
Contra
Special
Definition
RA
Prodrug->M1
Inhibit de novo pyrimadine synth.
Arrest in G1
GI
Myelosuppression
Alopecia
Hepatotoxicity
Teratogenesis
Pregnancy/breastfeeding
Hepatic disease
CYP inhibitor
Fast acting (4 wks)
long t1/2 (2 years until cleared)
Term
TNF-alpha inhibitors
Use
Mechanism
Adverse Effects
Interactions
Special
Definition
RA
Autoimmun/inflamm disease
Block TNF-alpha from getting to receptor
Infection risk
Hypersensitivity
autoantibody formation
malignancy
cytopenia
neurologic disorders
Not w/anakinra or abatacept
Dont combine 2 TNF-a inhib.
Fast onset 1 day
MTX synergism
Term
Anakinra
Use
Mechanism
Adverse Effects
Interactions
Special
Definition
RA
IL-1R antagonist
Immunosuppression
Dont combo w/ TNF-a inhib.
Ineffective alone-use in combo
Term
Abatacept
Use
Mechanism
Adverse Effects
Interactions
Special
Definition
RA
CTLA4+IgG
stops costim signal of B7 from APC to T cell
Immunosuppression
Worsen COPD
Dont combo w/ TNF-a inhib.
Ineffective alone-use in combo
Term
Rituximab
Use
Mechanism
Adverse Effects
Contra
Special
Definition
B cell lymphomas
leukemias
RA (w/ MTX)
mouse/human IgG to CD20
inhib B cell activation
B cell depletion for 6-9 months
Cytopenia
Infection risk up
Mucocutaneous rxns
Cardiac dysfunction
Hypersensitivity
additive hypotension
Term
Sulfasalazine
Use
Mechanism
Adverse Effects
Definition
IBD
RA
AICAR build up
Metabolites
1. Antibacterial
2. Inhib. prostaglandin and LTriene synthesis
Term
Adalimumab
Class
Structure
Definition
TNF-alpha inhibitor
Human IgG to TNF-a
Term
Etanercept
Class
Structure
Definition
TNF-alpha inhibitor
Human IgG + TNF receptor
Term
Golimumab
Class
Structure
Definition
TNF-alpha inhibitor
Human monoclonal Ab to TNF-a
Term
Certolizumab
Class
Structure
Definition
TNF-alpha inhibitor
Fab of Human Ab to TNF-a
Term
Infliximab
Class
Structure
Adverse Effects
Definition
TNF-alpha inhibitor
Human-mouse Ab to TNF-a
Worse side effects
Infusion rxn
Hepatic failure
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