Non-biologic DMARD

Drug deposited in tissues

Ocular toxicity is major side effect

Gold Compound

Taken up by macrophage and inhibit phagocytosis + lysosomal enzyme release

Decrease concentration of rheumatoid factor+IgG

Therapeutic effect may take 3-6 months

GU(loose stools) +Dermatitis most common side effects

Used for patients with methotrexate intolerance

Gold Compound

Taken up by macrophage and inhibit phagocytosis + lysosomal enzyme release

Decrease concentration of rheumatoid factor+IgG

Therapeutic effect may take 3-6 months

GU(loose stools) +Dermatitis most common side effects

Used for patients with methotrexate intolerance

Gold Compound

Taken up by macrophage and inhibit phagocytosis + lysosomal enzyme release

Decrease concentration of rheumatoid factor+IgG

Therapeutic effect may take 3-6 months

GU(loose stools) +Dermatitis most common side effects

Used for patients with methotrexate intolerance

Chelating Agent

Nonbiologic DMARD

Needs to be given on empty stomach

High incidence of potentially fatal drug reactions

Hypersensitivity common with penicillin

Non-biologic DMARD

Action of drug is on 5-aminosalicylic acid moiety

Slow acetylators of sulfapyridine show high incidence of adverse side effects

Most serious side effect is neutropenia

Inhibits dihydroorotate dehydrogenase (pyrimidine synthesis)

Hepatotoxicity(elevated liver enzymes) is major side effect

Biologic DMARD

dimeric fusion protien

It has human IgG

Binds TNF alpha+beta

Infections+malignancies are most common side effects

Biologic DMARD

chimeric IgG1 monoclonal antibody

Has human constant region+murine variable region

Neutrolizes TNF-alpha, not beta

Hypersensitivity to murine proteins(HACA positive) and increase in infections occur

Non-biologic DMARD

Rapid response + longest sustained efficacy

inhibits dihyrofolic acid reductase

Nephro+hepatotoxicty are common side effects