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20 Cards in this Set

  • Front
  • Back
Drugs against circulating Pro-Inflammatory Cytokines
Infliximab
Adalimumab
Etanercept
Anakinra
Miscellaneous Drugs
Penicillamine
Hydroxychloroquine/Chloroquine
Sulfasalazine
Cytotoxic Drugs
Methotrexate
Azathioprine
Leflunomide
Cyclosporine
MoA of Infliximab
Human/Mouse chimeric IgG1 monoclonal antibody; binds to soluble and transmembrane forms of TNF-alpha, preventing it from binding to its receptors on cells;
RoA: IV infusion every 8 weeks;
Clinical Uses: RA (w/ methotrexate), Crohn's disease, ulcerative colitis, ankylosing spondylitis, psoriatic arthritis, IBD
AE of Infliximab
Abdominal pain, fatigue, headache, infusion reactions, upper respiratory infections, urinary tract infections, hypersensitivity reactions, TB, lymphoma, and CHF
MoA of Adalimumab
Fully humanized monoclonal IgG1 antibody; blocks interaction of TNF-alpha with TNF receptors on cell surfaces; reduces levels of CRP, IL-6, ESR, MMP1, and MMP3;
RoA: SC injection every 14 days;
Clinical Uses: RA, ankylosing spondylitis, Crohn's disease, psoriasis with arthropathy
AE of Adalimumab
BLACK BOX WARNING: TB, invasive fungal infections, other opportunistic infections;
AEs: exacerbates CHF, serious infections, lupus-like syndrome
MoA of Etanercept
Recombinant fully human TNF receptor; acts like the receptor itself, tricking TNF-alpha & TNF-beta to bind to it instead of it's real receptors;
RoA: SC injection every week;
Clinical Uses: RA, psoriatic arthritis, juvenile arthritis
AE of Etanercept
AE: injection site rxns, autoantibody formation, hypersensitivity rxns, serious infections, increased risk of cancer;
CI: documented hypersensitivity, MS, sepsis, concurrent live vaccination
MoA of Anakinra
Recombinant human IL-1 receptor antagonist; binds to IL-1 and prevents it from binding to cells to produce inflammatory cytokines;
RoA: SC injection, every day;
Clinical Uses: RA
AE of Anakinra
Headache, injection site rxn, GI distress, infections, decreased white cell count, antibody formation to Anakinra
MoA of Penicillamine
Uncertain of MoA, chelates copper;
RoA: oral;
Clinical Uses: Wilson's disease, RA (if other drugs have failed)
AE of Penicillamine
Cutaneous lesions, blood dyscrasias/bone marrow suppression (may be fatal!), hypersensitivity rxns, myasthenia gravis;
CI: Goodpasture's Syndrome
MoA of Hydroxychloroquine/Chloroquine
Suppresses response of T-cells, decreases leukocyte chemotaxis, stabilizes lysosomal membranes, inhibits DNA/RNA synthesis, traps free radicals therefore reducing ROS;
RoA: Oral
Clinical uses:
Hydroxychloroquine - RA
Chloroquine - prophylaxis for malaria and malaria treatment, SLE, porphyria cutanea tarda
AE of Hydroxychloroquine/Chloroquine
Irreversible retinal degeneration (EYE EXAM is recommended EVERY 6 months!!), dermatitis, myopathy, GI irritation, and nightmares
MoA of Sulfasalazine
Salicylates class; inhibition of COX enzymes along with decreased PG synthesis;
RoA: oral;
Clinical Uses: ONLY NSAID used in RA and ulcerative colitis
MoA of Methotrexate
Usually anchor drug in combo therapy with anti-TNF-alpha agents (i.e. infliximab);
RoA: oral
Clinical Uses: RA (most commonly prescribed DMARD)
AE of Methotrexate
GI-related: nausea, vomiting, anorexia, diarrhea; leukopenia, MTX lung (hypersensitivity rxn), hepatotoxicity;
CPCs and LFTs are MANDATORY!!
MoA of Leflunomide
Inhibits pyrimidine synthesis by blocking dihydrotate dehydrogenase, also inhibits T & B- cell proliferation;
Clinical Uses: moderate to severe RA, psoriatic arthritis
AE of Leflunomide
GI toxicity, increased transaminases, rash & allergic rxns, reversible alopecia, headache, renal impairment; TERATOGENIC!