FallExam2Drugs

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Anonymous
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103222
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FallExam2Drugs
Updated:
2011-09-20 23:47:05
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FallExam2Drugs
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Description:
RA Drugs
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  1. Indomethacin
    NSAID; reduce swelling, inflammation, pain; Inhibition of COX → (-) of PG synthesis. Also inhib. of PMN adhesion, aggregation, & activation (ramifications uncertain).
  2. Naproxen
    NSAID
  3. Celecoxib
    NSAID; selective COX-2 inhibitor
  4. Prednisolone
    Glucocorticoid; regulate the transcription of genes with glucocorticoid response elements; immunosuppressant, anti-inflammatory; SE-infections/ulcers/hyperglycemia/osteoperosis/hypernatremia/hypokalemia
  5. Prednisone
    Glucocorticoid; regulate the transcription of genes with glucocorticoid response elements; immunosuppressant, anti-inflammatory, given with antihistamines; SE-infections/ulcers/hyperglycemia/osteoperosis/hypernatremia/hypokalemia
  6. Triamcinolone
    Glucocorticoid; synthetic corticosteroid
  7. Methylprednisolone
    Glucocorticoid; anti-inflammatory
  8. Azathioprine
    DMARD/non-biologic; for refractory RA or systemic involvement; rarely used; purine synthesis inhibitor; SE-myelosuppression/GI toxicity/carcinogenic; allopurinol can cause toxicities
  9. Cyclosporine
    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
  10. Methotrexate
    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
  11. Hydroxychloroquine
    DMARD/non-biologic; antimalarial; traps free radicas/stabilizes lysosomal mem; mild RA; combo with NSAIDS/methotrexate/sulfasalazine; prolonged response 3-6mo
  12. Sulfasalazine
    DMARD/non-biologic; antimalarial; anti-inflammatory, immunomodulator; mild RA; combo with methotrexate; 2-3mo response; more toxicity than hydroxychloroquine
  13. Etanercept
    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/
  14. Adalimunab
    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/
  15. Infliximab
    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/
  16. Anakinra
    IL-1 inhibitor; receptor antagonist; inhibits pro-inflam effects; monotherapy and combo with methotrexate; not given with TNF inhibitor; least effective;
  17. Abatacept
    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
  18. Rituximab
    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

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