2023-12-05T04:55:43+03:00[Europe/Moscow] en true <p>methotrexate, leflunomide, sulfasalazine, hydroxychloroquine</p>, <p>analog of folic acid; irreversibly inhibits dihydrofolate reductase; inhibiting proliferation and stimulating apoptosis in immune cells</p>, <p>b</p>, <p>b</p>, <p>b</p>, <p>nausea/mucosal ulcers (BW), elevated liver enzymes(BW), infection</p>, <p>a,b</p>, <p>Hydroxychloroquine, leflunomide, methotrexate, sulfasalazine </p>, <p>3 months; 2 years</p>, <p>a,b</p>, <p>diarrhea, elevated liver enzymes</p>, <p>Cholestyramine </p>, <p>inhibits pyrimidine synthesis; which leads to the inhibition of T-cell proliferation and reduction in B-cell ABs</p>, <p>a,d</p>, <p>unknown MOA; decreases: T cell response, B-cell proliferation, release of inflammatory cytokines</p>, <p>d</p>, <p>d</p>, <p>d</p>, <p>N/V, headache, rash, neutropenia</p>, <p>c, d</p>, <p>c</p>, <p>malaria, lupus</p>, <p>unknown; interferes with antigen process through suppressed t-cell response through leukocyte chemotaxis </p>, <p>-citinib suffix</p>, <p>small synthetic molecule that disrupts JAK-STAT signaling pathway; inhibiting inflammatory gene transcription</p>, <p>serious infections, cancer, increased CV events (thrombosis), death</p>, <p>JAKSTAT inhibitors</p>, <p>JAKSTATs; TB</p>, <p>limited efficacy; high risk of toxicity </p>, <p>prodrug of 6-mercaptopurine; an antimetabolite that inhibits lymphoid cell proliferation</p>, <p>xanthine oxidase; 6-thiouric acid</p>, <p>myelosuppression </p>, <p>allopurinol </p> flashcards
Pharmacology of DMARDs & tsDMARDs

Pharmacology of DMARDs & tsDMARDs

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  • methotrexate, leflunomide, sulfasalazine, hydroxychloroquine

    What are the classical DMARDs? (4)

  • analog of folic acid; irreversibly inhibits dihydrofolate reductase; inhibiting proliferation and stimulating apoptosis in immune cells

    Methotrexate MOA?

  • b

    Which is the first-line DMARD for RA?

    a) leflunomide

    b) methotrexate

    c) hydroxychloroquine

    d) sulfasalazine

  • b

    Which stimulates the release of adenosine?

    a) leflunomide

    b) methotrexate

    c) hydroxychloroquine

    d) sulfasalazine

  • b

    Which has the quickest onset of action?

    a) leflunomide

    b) methotrexate

    c) hydroxychloroquine

    d) sulfasalazine

  • nausea/mucosal ulcers (BW), elevated liver enzymes(BW), infection

    What are AEs of Methotrexate? (3)

  • a,b

    Which have BBW for teratogenicity?

    a) leflunomide

    b) methotrexate

    c) hydroxychloroquine

    d) sulfasalazine

  • Hydroxychloroquine, leflunomide, methotrexate, sulfasalazine

    Rank these drugs in terms of Half-life. (Longest-Shortest)

    Leflunomide, Methotrexate, Hydroxychloroquine, Sulfasalazine.

  • 3 months; 2 years

    Methotrexate requires women to be ________ clean before they can become pregnant while Leflunomide requires women to be ________ clean.

  • a,b

    Which has a BBW for hepatotoxicity?

    a) leflunomide

    b) methotrexate

    c) hydroxychloroquine

    d) sulfasalazine

  • diarrhea, elevated liver enzymes

    Leflunomide AE's? (2)

  • Cholestyramine

    _______ is used to increase the excretion of Leflunomide.

  • inhibits pyrimidine synthesis; which leads to the inhibition of T-cell proliferation and reduction in B-cell ABs

    Leflunomide MOA?

  • a,d

    Which are prodrugs?

    a) leflunomide

    b) methotrexate

    c) hydroxychloroquine

    d) sulfasalazine

  • unknown MOA; decreases: T cell response, B-cell proliferation, release of inflammatory cytokines

    Sulfasalazine MOA?

  • d

    Which medication has salicylate and sulfa metabolites?

    a) leflunomide

    b) methotrexate

    c) hydroxychloroquine

    d) sulfasalazine

  • d

    Which can cause urine to turn yellow-orange?

    a) leflunomide

    b) methotrexate

    c) hydroxychloroquine

    d) sulfasalazine

  • d

    Which med has 30% patient discontinuation?

    a) leflunomide

    b) methotrexate

    c) hydroxychloroquine

    d) sulfasalazine

  • N/V, headache, rash, neutropenia

    What are the AE's of Sulfasalazine? (4)

  • c, d

    Which is safe in pregnancy?

    a) leflunomide

    b) methotrexate

    c) hydroxychloroquine

    d) sulfasalazine

  • c

    Which can cause irreversible retinal damage?

    a) leflunomide

    b) methotrexate

    c) hydroxychloroquine

    d) sulfasalazine

  • malaria, lupus

    What are the main uses of Hydroxychloroquine? (2)

  • unknown; interferes with antigen process through suppressed t-cell response through leukocyte chemotaxis

    Hydroxychloroquine MOA?

  • -citinib suffix

    What are the tsDMARDs?

  • small synthetic molecule that disrupts JAK-STAT signaling pathway; inhibiting inflammatory gene transcription

    Janus Kinase inhibitors MOA?

  • serious infections, cancer, increased CV events (thrombosis), death

    What are the BBW for JAK-STAT inhibitors? (4)

  • JAKSTAT inhibitors

    You should NEVER combine biologics and __________.

  • JAKSTATs; TB

    Patients that take _______ should be tested for _________.

  • limited efficacy; high risk of toxicity

    Why is Azathioprine not commonly used? (2)

  • prodrug of 6-mercaptopurine; an antimetabolite that inhibits lymphoid cell proliferation

    Azathioprine MOA?

  • xanthine oxidase; 6-thiouric acid

    __________ splits mercaptopurine into _________ causing renal excretion

    along with small amounts of parent prodrug and mercaptopurine.

  • myelosuppression

    What is the main AE of Azathioprine?

  • allopurinol

    Which medication would require a dose reduction when used in

    combination with Azathioprine?