-
name 4 glucocorticoids
- prednisone
- cortisone
- hydrocortisone
- dexamethasone
-
chlorquine
and
hydroxychloroquine
- (aralen)
- (plaquenil)
- DMARD
- MAO- depressed t cell stimulation (immunosuppression)
- safest of DMARDs
- a.r.- irreversible rentinal toxicity
-
azathioprine
- (imuran)
- DMARD
- prevents tissue rejection (immunosupprestion)
- moa-inhibits lymphocyte proliferation
- a.r.-relatively toxic, fever, chills, sore throat, fatigue
-
auranofin
- (ridaura)
- DMARD
- gold therapy, no longer used
- moa-inhibits t cells and phagocytes
- a.r.- used fairly early, 1/3 exp. toxic effect- GI distress, rashes and itching
-
leflunomide
- (Arava)
- DMARD
- slows formation of bone erosions within 1 month
- moa-inhibits RNA synthesis in lymphocytes (reduces jnt inflammation)
- a.r.- GI distress, allergic reactions and hair loss
-
methotrexate
- (folex, Rheumatrex)
- DMARD
- decreases synovitis and bone erosion
- antimetabolite/anticancer
- most effective DMARD used first in treatment
- moa- impairs DNA and RNA synthesis, inhibits folic acid synthisis, increases adenosine which inhibits immune response
- a.r.- relativley toxic,
- GI, pulmonary, hematolgic, liver and hair loss problems.
-
penicillamine
- (cuprimine)
- DMARD
- derivative of penicillin
- moa-depresses t-cell function
- a.r.- fairly toxic, used rarely
- causes fever, jnt pain, rashes and itching
-
etanercept
- (Enbrel)
- DMARD
- Tumor necrosis factor inhibitor
- moa-binds to TNF-alpha (TNF promotes inflammation and jnt erosion)
- AR- prone to upper respiratory tract infections, liver disease, heart failure
-
anakinra
- (kineret)
- DMARD
- blocks effect of interleukin-1
- (interleukin-1- cytokine that promotes jnt inflammation)
- ar.- pts. may be more vulnerable to bacterial infections
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