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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).
    • RA
  2. Naproxen
    • NSAID
    • RA
  3. Celecoxib
    • NSAID; selective COX-2 inhibitor
    • RA
  4. Prednisolone
    • Glucocorticoid; regulate the transcription of genes with glucocorticoid response elements;
    • immunosuppressant, anti-inflammatory;
    • SE-infections/ulcers/ hyperglycemia/osteoperosis/ hypernatremia/hypokalemia
    • RA
  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
    • RA
  6. Triamcinolone
    • Glucocorticoid; synthetic corticosteroid
    • RA
  7. Methylprednisolone
    • Glucocorticoid; anti-inflammatory
    • RA
  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
    • RA
  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;
    • RA 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;
    • RA 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;
    • RA 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;
    • RA monotherapy and combo with methotrexate;
    • not given with TNF inhibitor; least effective;
  17. Abatacept
    • RA; 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;
    • RA combo with methotrexate or DMARD not recommended;
    • black box warning-fatal infusion rxns;
    • SE-infection/reactivation of HepB
Card Set
RA (better organized)
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