NURS 165 Study Guide - Final Guide: Bioavailability, Chloroquine, Leflunomide
RA Drugs
Class
Sub-class
Mechanism
Drug
Indication
Other
Side Effects
Other
NSAID
Non-selective
Inhibits COX1 and 2
Ibuprofen
Pain from
inflammation
GI distress, tinnitus,
peripheral edema, renal
dysfunction
hRXN, SJS
Selective
Inhibits COX2
Celecoxib
RA, OA, AS,
acute pain,
dysmenorrhea
Less GI toxicity,
expensive
Dyspepsia, ab. pain, renal
injury, Inc. CV Risk (low
dose for short time)
hRXN (sulfur), caution
in preg.
Glucocorticoid
Inhibits mediator
synthesis, sup.
phagocyte infiltration
& lymphocyte
proliferation
Prednisone
Severe RA
symptoms
Can be given as
intra-articular
injections (localized
effect), taper then
discontinue
(large doses, LT use)
Infection, osteoporosis,
slow growth, glucose
intolerance, Na/ H2O
retention, hypokalemia
Avoid w. live virus
vaccine, systemic
fungal infection
(infection risk)
Caution preg,
lactation, peds
DMARD
Nonbiological
Methotrexate
Also used in cancer-
PROFOUND effects,
FA supplementation
reduces GI/ hepatic
toxicity
GI effects, hair loss
(alopecia), anemia,
neutopenia
NO preg, use
contraception,
moouth sores,
dermatitis, interacts
with ETOH (liver
dysfinction)
prodrug, sup. T and B
cells proliferation
Leflunomide
RA
Infections, HTN, nausea,
liver dysfunction,
diarrhea, alopecia,
anemia,
thrombocytopenia
Rash, SJS
NO preg use
contraception
?, blocks TLRs that
produce interferon
that helps APCs show
Ag to T cells
Hydroxy-
chloroquine
Antimalarial,
RA, SLE
take with food or
milk to increase
bioavailability
Retinal damage/ blind
(r/t dose), corneal
changes, anemia, alopecia
Biological
Prevents TNF binding
to natural receptors
Etanercept
Mod-severe RA,
psoriatic
arthritis, AS
In RA- suppresses
build-up of bone
erythema/swelling at
injection site, infections
esp. TB (test for TB
before), tumorogenic,
neuro-demyelination (MS
symptoms)
SJS, rash
opportunistic
infections
TNF antibody
Infliximab
RA, psoriasis,
Chron's,
ulcerative colitis
IV, pretreat w.
antihistamine,
glucocorticoid (risk
for hRXN)
Infections (test for TB
before), anemia, cancer,
neurologic issues, HF,
liver dysfunction
hRXNs- pre-treatment
regimen,
slow/interrupted
infusion
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Document Summary
Can be given as intra-articular injections (localized effect), taper then discontinue. ?, blocks tlrs that produce interferon that helps apcs show. Mod-severe ra, psoriatic arthritis, as take with food or milk to increase bioavailability. Iv, pretreat w. antihistamine, glucocorticoid (risk for hrxn) Dyspepsia, ab. pain, renal injury, inc. cv risk (low dose for short time) (large doses, lt use) Infection, osteoporosis, slow growth, glucose intolerance, na/ h2o retention, hypokalemia. Infections, htn, nausea, liver dysfunction, diarrhea, alopecia, anemia, thrombocytopenia. Retinal damage/ blind (r/t dose), corneal changes, anemia, alopecia erythema/swelling at injection site, infections esp. Tb (test for tb before), tumorogenic, neuro-demyelination (ms symptoms) Infections (test for tb before), anemia, cancer, neurologic issues, hf, liver dysfunction. Other hrxn, sjs hrxn (sulfur), caution in preg. Avoid w. live virus vaccine, systemic fungal infection (infection risk) No preg, use contraception, moouth sores, dermatitis, interacts with etoh (liver dysfinction)
