Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
13 Cards in this Set
- Front
- Back
- 3rd side (hint)
|
Define rheumatoid arthritis , it's pathogenesis? |
DEFINITION - RA is a chronic progressive, autoimmune disease in which there is 1.joint inflammation, 2.synovial membrane proliferation, and 3.destruction of articular cartilages. PATHOGENESIS- Pro-inflammatory cytokines play important roles in the pathogenesis of RA, but TNF-α are particularly important in the inflammatory process .Though the joints are particularly affected, other body organs are also involved since the underlying pathology is a systemic autoimmune disorder . |
|
|
|
Classify drugs used in Rx of rheumatoid arthritis |
1. NSAIDS 2. glucocorticoids 3. DMARDS - a) non - biological DMARDS b) biological DMARDS DMARDS means disease modifying anti rheumatic drugs
|
|
|
|
Egs of Glucocorticoids |
1. Predisolone 2. Hydrocortisone 3. Dexamethasone.. Used for the symptomatic relief of pain, swelling, joint stiffness.. They don't alter the disease process ( even NSAIDS, only DMARDS do) |
|
|
|
About DMARDS - give Egs of biological and non biological DMARDS |
1. Non Biological DMARDS - a) methotrexate b) sulfasalazine c) leflunomide d) hydroxychloroquine e) gold salts f) D- penicillamine
2. Biological DMARDS a) adalimubab b) infliximab c) abatacept d) etanercept e) rituximab f) levamisole |
Non- biological - MS GPLH biological - AIR RALE |
|
|
About DMARDS - what are they? |
DMARDs (Disease Modifying Anti-Rheumatism Drugs) - The DMARDs - suppress 1.the disease process, 2.destruction of joint surfaces and 3. can bring about remission. However, they are slow-acting and take between 6 weeks to 6 months to produce clinical response. Non-biological DMARDs (Methotrexate, Sulfasalazine, Leflunomide, Hydroxychloroquine, chloroquine, Gold salts, D-penicillamine b. Biological DMARDs (Adalimubab, Infliximab, Abatacept, Etanercept, Rituximab, Levamisole). |
|
|
|
DMARDS are fast or slow acting? |
Are slow acting & take between 6 weeks to 6 months to produce clinical response. |
|
|
|
Aim of treatment of rheumatoid arthritis |
Aims of treatment 1.To relieve joint pain and swelling – primary aim 2. To reduce and prevent damage to the joints and other organs. 3. Arrest of disease process |
|
|
|
What is the primary aim for treatment of rheumatoid arthritis |
To relieve joint pain and swelling |
|
|
|
Drug regimen in treatment of rheumatoid arthritis |
Drug regimen 1.In mildly active RA, initiate treatment with NSAID then add DMARDs (hydroxychloroquine or sulfasalazine). 2. In severely active RA, initiate treatment with glucocorticoids then add DMARD (methotrexate) 3. In resistance to initial DMARD, switch to another DMARD while continuing anti-inflammatory drugs. |
|
|
|
Use of methotrexate S/E |
1. Uses alone or in combination 2. Mainstay of Rx in patients with a. Rheumatoid arthritis / psoriatic arthritis 3. Mucosal ulceration, nausea, cytopenia ( ezp wbc) , liver cirrhosis, an acute pneumonia lime syndrome , 4. Leucovorin ( folinic acid) reduced the severity of A.E... |
|
|
|
Uses of hydroxychloroquine S/E |
1. Rheumatoid arthritis 2. Lupus 3. Malaria S/E a. Ocular toxicity - irreversible retinal damage and corneal deposit b. CNS disturbance c. GIT upset d. Skin discoloration and eruption |
|
|
|
What is leflunomide |
It is an immunomodulatory agent, that preferencially cause cell arrest of the autoimmune lymphocytes through its action on dihydro-orotate dehydrogenase ( DHODH) . DHOHD is required for Pyrimidine synthesis , leflunomide is a reversible inhibitor of DHOHD. |
|
|
|
Infliximab us not indicarffor monotherapy during Rx as |
This leads to the development of anti - Infliximab antibodies, resulting in reduced efficacy |
|
