Arthritic Drugs

• Drugs Against circulating pro-inflammatory cytokines:
• Monoclonal ab = Infliximab & Adalimumab
• Receptor = Etanercept
• Receptor antagonist = Anakinra

• Miscellaneous:
• Penicillamine
• Hydroxychloroquine
• Sulphasalazine

• Cytotoxic Drugs:
• Methotrexate
• Azathioprine
• Leflunomide
• Cyclosporine

• Monoclonal
• MOA: binds TNF-a

load up w/ methrotrexate 100mg X 3 days

• A/E: hypersensitivity
• TB
• hepatosplenic lymphoma

• Human Ab derived
• MOA: binds Tnf-a & dec infl. agents

given every 14 days

Black box: TB & fungal infections

• receptor
• MOA: binds TNF-a

1X/week

• A/E: site reaction
• hypersensitivity
• infection

IL-1 antagonist

1X/day

A/E: Infections

• A/E:
• Blood dyscrasias
• BM supression

• MOA: dec T cell chemotaxis
• trap free radicals

S/E: irreversible retinal degeneration

metabolized by bacteria to mesalmine

slow acetylators --> dec excretion rate

• A/E:
• hypersensitivity
• hematological effects

Cytotoxic

adjuvant w/ folate

• A/E:
• leukopenia
• MTX lung
• hepatoxicity

Cytotoxic

MOA: No denovo synthesis -> no T & B cell proliferation

• A/E:
• cytopenias
• renal
• teratogenic

Uricosuric

• MOA:
• dec reabsorption
• inc excretion
• BUT opposite effect on Penicillin

Uricosuric

MOA: dec reabsorption

Chronic treatment of uric acid overproduction

MOA: utilize xanthine oxidase -> oxypurinol

w/ theophylline -> inc [methyl xanthine]

Acute Gouty attack

MOA: binds microtubular filaments -> no movement of WBC

• A/E:
• myopathy
• agranulocytosis
• aplastic anemia
• alopecia

• NSAIDS:
• ibuprofen
• indomethacin
• phenylbutazone

Glucocorticoids: prednisone

• Colchicine
• indomethacin

• Uricosurics:
• probenacid
• supfinpyrazone

xanthine oxidase inhibitors: allopurinol

uric acid metabolism: rasburicase