DMARDs
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| Methotrexate | DHFR inhibitor; cytotoxic to lymphocytes; 1st line in moderate-severe | Hepatotoxicity, acute renal failure
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| Sulfsalazine | Sulfapyridine decreases B cell function; 5-ASA inhibits COX | Hemolysis in G6PD
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| Glucocorticoids | Decrease LTs, ILs, PAF | ACTH suppression, cushingoid state, osteoporosis, GI distress, glaucoma
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| Gold salts | Decrease lysosomal & macrophage function | Dermatitis, nephrotoxicity, cholestatic jaundice
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| Penicillamine | Suppresses T cells & RF (Cu chelator in Wilson's dz) | Proteinuria, autoimmune disease
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| Leflunomide | Inhibits pyrimidine synthesis (inhibits DHOD [dihydroorotate dehydrogenase], decreasing UMP, decreasing ribonucleotides); arrests lymphocytes in G1 phase | Alopecia, rash, diarrhea, hepatotoxicity
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| Adalimumab | Anti-TNF antibody | Increased risk of infection (screen pt for TB)
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| Hydroxychloroquine | Stabilizes lysosomes; decreases chemotaxis | Cinchonism, hemolysis in G6PD, retinal deposits (pts need regular optho exams)
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