DMARDs

Question 1

DMARDs

Answer 1

disease modifying anti rheumatic drugs

Question 2

uses for DMARDs

Answer 2

Used both to control symptoms & slow/stop the progression of the disease
Used for rheumatoid arthritis & other chronic inflammatory diseases

Question 3

example conventional synthetic DMARDs (csDMARDs)

Answer 3

methotrexate

Question 4

methotrexate is also used for?

Answer 4

psoriasis, Crohn;s disease

Question 5

csDMARDs mechanism

Answer 5

not fully understood
mech- non-specific which results in side effects
require regular monitoring & takes time for their effects (7 months)

Question 6

methotrexate inhibits:

Answer 6

the enzyme dihydrofolate reductase (involved in folate metabolism)
AICAR transformylase

Question 7

bDMARDs

Answer 7

biological DMARDs

Question 8

Characteristics of bDMARDs

Answer 8

• highly specific in their mech of action
• Good efficacy
• biologicals/ biopharmaceuticals

Question 9

most biologics are manufactured using?

Answer 9

recombinant DNA technology

Question 10

difference in manufacturing processes between bDMARDs and csDMARDs

Answer 10

biologics- manufacturing process highly complex & difficult to replicate
conventional- manufacturing process easy to replicate (chemical synthesis)

Question 11

which one is more stable csDMARDs or bDMARDs?

Answer 11

conventional

Question 12

possible strategies for treating RA

Answer 12

target inflammatory cells
target pro-inflammatory cytokines

Question 13

adalimumab and infliximab are examples of?

Answer 13

TNF- alpha inhibitors

Question 14

anakinra

Answer 14

anti IL-therapy
recombinant antagonist of IL-1 receptor=no signal

Question 15

Canakinumab

Answer 15

anti IL- therapy
antibody that binds to IL-1=no signal

Question 16

tocilizumab

Answer 16

anti IL-6
binds and no signal transduction

Question 17

rituximab

Answer 17

antibody specific for CD20, which is expressed in B cells

Question 18

Rituximab aims to ?

Answer 18

deplete B cells

Question 19

3 ways (mechanism of action) rituximab

Answer 19

antibody dependent cellular cytotoxicity (ADCC)
complement mediated cytotoxicity
apoptosis

Question 20

mechanism of abatacept

Answer 20

inhibits the “second signal” required for T-cell activation
prevents co-stimulation
prevents activation of T-cells

Question 21

advantages of bMARDs

Answer 21

specific mechanism of action
high efficacy (symptom relief & slow/stop progression of disease)

Question 22

disadvantages of bMARDs

Answer 22

side effect: increase susceptibility to infection & increased risk of malignancy
Route of administration: IV, subcutaneous
manufactured using a living organism
unstable
expensive