FallExam2Drugs

NSAID; reduce swelling, inflammation, pain; Inhibition of COX → (-) of PG synthesis. Also inhib. of PMN adhesion, aggregation, & activation (ramifications uncertain).

NSAID

NSAID; selective COX-2 inhibitor

Glucocorticoid; regulate the transcription of genes with glucocorticoid response elements; immunosuppressant, anti-inflammatory; SE-infections/ulcers/hyperglycemia/osteoperosis/hypernatremia/hypokalemia

Glucocorticoid; regulate the transcription of genes with glucocorticoid response elements; immunosuppressant, anti-inflammatory, given with antihistamines; SE-infections/ulcers/hyperglycemia/osteoperosis/hypernatremia/hypokalemia

Glucocorticoid; synthetic corticosteroid

Glucocorticoid; anti-inflammatory

DMARD/non-biologic; for refractory RA or systemic involvement; rarely used; purine synthesis inhibitor; SE-myelosuppression/GI toxicity/carcinogenic; allopurinol can cause toxicities

DMARD/non-biologic; limited use; rarely used; immunosuppressant; binds calcineurin phosphatatse and decree IL-2; SE-neprotoxicity/neurotoxicity/hyperuricemia; Erythromyocin and grapefruit can slow clearance

DMARD/non-biologic; inhib dihydrofolate reductase; depletion THF required for purine sin; early RA therapy; fastest acting DMARD; SE-bone marrow suppression/stomatitis/pulmonary/teratogenic; leucovorin reduce toxicity; avoid alcohol

DMARD/non-biologic; antimalarial; traps free radicas/stabilizes lysosomal mem; mild RA; combo with NSAIDS/methotrexate/sulfasalazine; prolonged response 3-6mo

DMARD/non-biologic; antimalarial; anti-inflammatory, immunomodulator; mild RA; combo with methotrexate; 2-3mo response; more toxicity than hydroxychloroquine

DMARD/biological; TNF-a Inhibitors; fusion protein; binds TNF-a, prevents activation of receptors; monotherapy or combo with methotrexate; SE-skin rxn/infection/malignancy/autoimmune/CHF; contraindications-SLE/MS/infections/

DMARD/biological; TNF-a Inhibitors; humanized ant-TNF-a monoclonal Ab; monotherapy or combo with methotrexate; SE-skin rxn/infection/malignancy/autoimmune/CHF; contraindications-SLE/MS/infections/

DMARD/biological; TNF-a Inhibitors; chimeric anti-TNF-a monoclonal Ab; combo with methotrexate for pts who don't respond to methotrexate alone; SE-skin rxn/infection/malignancy/autoimmune/CHF; contraindications-SLE/MS/infections/

IL-1 inhibitor; receptor antagonist; inhibits pro-inflam effects; monotherapy and combo with methotrexate; not given with TNF inhibitor; least effective;

Selective Costimulation Modulator; fusion protien homologue of CD28 TCR for B7; binds to B7 with higher affinity than CD28; inhibits TNF-a/interferion-y/IL-2; not given with another DMARD; SE-HTN/headache/anaphylaxis/infections

CD20 Ab; chimeric monoclonal Ab agains CD20; Bcell specific; combo with methotrexate or DMARD not recommended; black box warning-fatal infusion rxns; SE-infection/reactivation of HepB