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36 Cards in this Set

  • Front
  • Back
what are DMARDS
disease modifying agents of rheumatoid disease
key factors of DMARDS
1.) diverse group
2.) different benifits and problems
3.) combos improve efficacy
4.) considered if NSAIDS fail
Methotrexate
treatment alone or in combo
used in RA & PA
once weekly dosing
response occurs in 3-6 weeks
What are the SE of Methotrexate?
1.) mucosal ulcers
2.) nausea
3.) cytopenias
4.) liver cirrhosis
Leflunamide(Arava)
arrests cell development of AI lymphocytes
RA: slows progression of DZ
PK: Oral
SE of Leflunamide
1.) HA
2.) Diarrhea
3.) Nausea
4.) Weight Loss
5.) alopecia, rashes
TERATOGEN
Chloroquine
&
Hydroxychloroquine
Used for Malaria
anti-inflammatory action
slows progression of bone lesions in RA: induces remission
SE of Chloroquine & Hydroxy
1.) GI
2.) Blurry vision
3.) Pruritis
Penicillamine
Cystine analog, slows RA progression
used after gold salts but before steroids
SE of Penicillamine
1.) skin problems
2.) nephritis
3.) aplastic anemia
Gold Salts
macrophages take up & supress phagocyte & Lysosomal NZY activity

USED LESS B/C OF $ and monitoring
Anti-cytokine therapies in RA
cytokines play key role in DZ states
Ethanercept
Anti-cytokine
aka Embrel
uses: RA and PA
mech of action of Ethanercept
binds 2 TNF together making inactive
SE of Ethenercept
well tolerated
long term concern for tumor
Infliximab
aka Remicade, anti-cytotoxic
Binds to TNF
Uses for Infliximab
Chron's DZ for 6 week Tx
IV over 2 hrs
SE of Infliximab
infection
cytopenias
lymphoma
Adalimumab
aka Humira, anti-cytotoxic
Binds TNF receptor site
SQ
uses of adalimumab
RA after DMAEDS fail
Anakinra
aka Kineret, anti-cytotoxicIL-1 antagonist
What drug is used for acute gout?
Indomethacin
True or False
you can take ASA with inomethacin
Fasle
they compete w/ UA for renal excretion
What drugs are used for chronic gout?
Allopurinol
Uricosurics
Colchicine
Allopurinol
blocks synthof final steps of UA
Useful in Hx of UA stones
SE of Allopurinol
GI
Rash
Uricosurics
Probenacid & Sulfinpyrazone
increases excretion of UA and block renal absorption of UA
Colchicine
Maintnance
Blocks granulocyte mobility and cell division and production of leukotrienes
Autocoids & Antagonists
Misoprostol
Prostaglandin replacement
Cytotec
Uses of Misprostol
protect stomach from NSAID
Abortifacient
Migraine medication
Triptans & Hydroergotamine
Triptans
Sumatriptan(Imitrex)
Zolmitriptan(NO IN CAD)
How to Triptans & Hydroergotamines work?
act on seratonin receptor subgroup found on nerve endings
Dihydroergotamine
similar action to triptans
Nausea most common side effect
Consider migrain Prophylaxis for;
pts with 3+ migraines/month
impacting quality of life
have >2 requireing intervention
what drug groups are used for prophylaxis?
B-blockers: propanolol
Anticonvulsants:amitriptyline
Ca channel bloackers: verapamil