Arthritic Disease Drugs

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Author:
Anonymous
ID:
110250
Filename:
Arthritic Disease Drugs
Updated:
2011-10-19 13:46:56
Tags:
Ross med medical school pharmacology arthritis s3m2 s3 Turnbull
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Description:
Drugs from Dr. Turnbull's "Drugs for Arthritic Diseases" lecture; includes the DMAR (disease-modifying antirheumatic) drugs against circulating pro-inflammatory cytokines, cytotoxic drugs, and miscellaneous drugs.
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  1. What four drugs act against circulating proinflammatory cytokines?
    • Infliximab (monoclonal antibody)
    • Adalimumab (monoclonal antibody)
    • Etanercept (receptor)
    • Anakinra (receptor agonist)
  2. What three drugs fall under the miscellaneous category? Give a quick synopsis of each.
    • Penicillamine:
    • Hydroxychloroquine:
    • Sulphasalazine:
  3. What are the four cytotoxic drugs? Give a quick synopsis of each.
    • Methotrexate:
    • Azathioprine:
    • Leflunomide:
    • Cyclosporine:
  4. What is the therapeutic goal of anti-rheumatoid arthritis therapy?
    To arrest the progress of the disease (remission) and to regulate the debilitating pain.
  5. What is the general therapeutic strategy for the three DMARD classes as a whole?
    Almost always use anti-cytokines and miscellaneous in conjuction, and more commonly using cytotoxic tx as well. This prevents upregulation of inflammation and kills off rapidly dividing hematopoietic cells.
  6. What three types of cells produce IL-1 and TNF-α in rheumatoid arthritis?
    • Dendritic cells
    • Macrophages
    • Synovial cells
  7. What are the 5 major roles of IL-1 in rheumatoid arthritis?
    • Stimulates cytokine synthesis (PGE2, NO, metalloproteases)
    • Endogenous pyrogen
    • Augments T- and B-cell, and macrophage activation
    • Stimulates cartilage destruction
    • Stimulates integrin and selectin production in endothelium
  8. What are the 4 major roles of TNF-α in rheumatoid arthritis?
    • Pro-inflammatory
    • Cytotoxic
    • Stimulates all leukocytes (proliferation, Ab production, etc)
    • Stimulates cartilage destruction
  9. Infliximab: Give the structure, RoA, MoA, primary uses, and adverse effects
    • Human/mouse chimeric IgG1 MAB
    • RoA: IV @ 0, 2, and 6wks, then every 8
    • MoA: binds soluble and transmembrane TNF-α
    • Uses: Rheumatoid Arthritis, Crohn's, ulcerative colitis, ankylosing spondylitis, psoriatic arthritis
    • Adverse: hypersensitivity, infections (TB), hepatosplenic lymphoma (T-cell), heart failure

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