ARDD Drug List KB

ARDD Pharmacology Drug List Drugs Mechanism of Action Major Major Indications Adverse Effects tNSAIDs Ibuprofen, Naproxen, Indomethacin Inhibit COX ? ? prostaglandins Avoid in GI bleed, renal CKD/ulce OA, RA, gout flares toxicity, CV naproxen risk CV profile Selective COX-2 inhibitor Celecoxib Selective COX-2 inhibition OA, RA (if GI risk) ?CV risk Therapeutic Subclass Category Corticosteroids SymptomRelievers / NonDMARDs Microtubule inhibitor ? NF-?B, cytokines; ? RA flares, SLE, Prednisone, immune cell vasculitis, derm Methylprednisolone migration flares Colchicine Folate antagonist Other Comment Less GI ri than tNSA Signs/symptoms of iatrogenic Bridge the Cushing’s while syndrome DMARDs Binds tubulin ? inhibits neutrophil chemotaxis Acute gout flares; prophylaxis when initiating Diarrhea, urate-lowering myopathy therapy; CPPD (offlabel) Methotrexate (MTX) Inhibits DHFR ? ? purine/thymidylate synthesis; ? adenosine Dose adju CKD Hepatotox RA (anchor), cytopenias PsA, psoriasis, stomatitis, SLE (skin) alopecia, teratogeni Conventional DMARDs Alters lysosomal Hydroxychloroquine activity, ? TLR (HCQ) signaling SLE (skin/joint), RA (mild) Retinopath upset Prodrug ? Sulfasalazine (SSZ) sulfapyridine; antiinflammatory RA, PsA, arthritis GI upset, r cytopenias RA, PsA Hepatotox alopecia, teratogeni Pyrimidine synthesis Leflunomide inhibitor Inhibits dihydroorotate dehydrogenase Biologic DMARDs TNF inhibitors Etanercept, Infliximab, Adalimumab, Certolizumab (can use in pregnancy!) RA, PsA, AS, psoriasis, JIA IL-6 inhibitors Tocilizumab, Sarilumab Block IL-6 receptor Infections, RA, GCA, systemic ?lipids, GI JIA perf, cytopenias T-cell costimulation blocker Abatacept CTLA4-Ig fusion protein RA, PsA B-cell depleting agent Rituximab Anti-CD20 HBV RA, SLE, vasculitis, reactivation, pemphigus PML B-cell survival blocker Belimumab Anti-BLyS (BAFF) SLE (skin/joint) Infections, depression IFN receptor blocker Anifrolumab Blocks type I IFN receptor SLE (mod-severe) Zoster, URIs Good for s SLE IL-17 inhibitors Secukinumab, Ixekizumab Block IL-17A Psoriasis, PsA, AS Infections, candidiasis Best for sk psoriasis IL-23 inhibitors Guselkumab, Risankizumab Block IL-23 ? ? Th17 Psoriasis, PsA Infections (fungal, viral) Effective f skin > join IL-4/IL-13 inhibitor Dupilumab Monoclonal antibody directed against IL-4 and IL-13 JAK inhibitors Tofacitinib, Baricitinib, Upadacitinib Block JAK-STAT pathway Infections (zoster), RA, PsA, AS cytopenias thrombosi PDE4 inhibitor Apremilast Inhibits PDE4 ? ? cAMP GI upset, Psoriasis, PsA weight los depression Targeted Synthetic DMARDs Infections (TB/fungal) Screen TB/HBV; onset Neutralize TNF-? Monitor la Infections, COPD exacerbation After TNF failure IMPDH inhibitor Mycophenolate mofetil (MMF) SLE nephritis, Inhibits IMPDH ? ? dermatomyositis, guanosine nucleotides vasculitis Purine analog Azathioprine Purine analog ? inhibits DNA synthesis Alkylating agent Alkylates DNA ? Cyclophosphamide crosslinks Calcineurin inhibitors Cyclosporine, Tacrolimus, Voclosporin Nephrotoxicity,Topical Inhibit calcineurin ? ? Psoriasis, AD, lupus HTN, tacrolimus IL-2 transcription nephritis neurotoxicity for AD/vit Xanthine oxidase inhibitor Allopurinol UrateInhibits xanthine lowering oxidase ? ? uric acid therapy Rash, SJS hypersens (HLA-B*5 Febuxostat Inhibits xanthine oxidase Urate-lowering therapy Alternativ allopurino CKD Other Immunosuppressives Gout Drugs Xanthine oxidase inhibitor Only bolded names will be tested on exam. GI upset, cytopenias, infections Severe autoimmu disease BM Avoid wit SLE, derm, myositis suppression, allopurino hepatotoxicity Severe SLE, vasculitis, scleroderma lung Infertility, hemorrhagic cystitis CV risk? Reserved severe dis