1 / 24

Disease –Modifying Antirheumatic drugs

Disease –Modifying Antirheumatic drugs . Slow Acting Anti-inflammatory Drugs ). BY. PROF. AZZA EL-MEDANY. DR. OSAMA YOUSF. OBJECTIVES. At the end of the lecture the students should Define DMARDs

roy
Download Presentation

Disease –Modifying Antirheumatic drugs

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Disease –Modifying Antirheumatic drugs Slow Acting Anti-inflammatory Drugs )

  2. BY PROF. AZZA EL-MEDANY DR. OSAMA YOUSF

  3. OBJECTIVES At the end of the lecture the students should Define DMARDs Describe the classification of this group of drugs Describe the general advantages & criteria of this group of drugs Describe the general clinical uses

  4. OBJECTIVES ( Continue) • Know some examples of drugs related to DMARDS. • Describe the mechanism of action , specific clinical uses , adverse effects & contraindications of individual drugs.

  5. General Features • Low doses are commonly used early in the course of the disease • Used when the disease is progressing & causing deformities ( they stop the progress of the disease ) • Used when the inflammatory disease is not responding to NSAIDs • Can not repair the existing damage , but prevent further deformity • Have no analgesic effects • Slow onset their effects take from 6 weeks up to 6 months to be evident

  6. General Clinical Uses • Treatment of rheumatic disorders • Combination therapies are both safe & efficacious

  7. Hydroxychloroquine Mechanism of action : • Stabilization of lysosomal enzyme activity • Trapping free radicals • Suppression of T lymphocyte cells

  8. Pharmacokinetics • Rapidly & completely absorbed following oral administration. • Has a very large volume of distribution • Penetrates into C.N.S. & traverse the placenta • Metabolized in liver

  9. Continue • Some metabolic products retain antimalarial activity • Both parent drug & metabolites are excreted in the urine • The excretion rate is enhanced in acidic urine

  10. Adverse Effects • Pruritius • Headaches • GIT upset • Blurred vision • Discoloration of nail beds & mucous membranes • Irreversible retinal damage

  11. Methotrexate • Immunosuppressant drug • Response to methotrexate occurs sooner than for other slow acting drugs. • Doses of methotrexate are much lower than those needed in cancer chemotherapy • Given once a week

  12. Mechanism of action • Inhibition of polymorphonuclearchemotaxis • Suppression of T lymphocyte Cells

  13. Nausea • Cytopenias Adverse Effects • Liver cirrhosis • Acute pneumonia –like syndrome • Mucosal ulceration

  14. Tumor necrosis factor –α (TNF-α ) blocking agents

  15. Infliximab A chimeric antibody ( 25% mouse, 75% human)

  16. Mechanism of action • Binds to human TNF-α resulting in inhibition of macrophage & T cell function

  17. Infliximab • Given as IV infusion over at least two hours • Half-Life 8-12 days • Given every 8 weeks regimen. • Elicits up to 62% incidence of human antichimeric antibodies. • Concurrent therapy with methotrexate decreases the prevalence of human antichimeric antibodies

  18. Upper respiratory tract infections Pancytopenia Adverse effects Infections Activation of latent tuberculosis Infusion reactions

  19. Comparison between NSAIDs & DMARDs DMARDs NSAIDs • Slow onset of action • Arrest progression of the disease • Prevent formation of new deformity • Used in chronic cases when deformity is exciting • No analgesic effect • Rapid onset of action • No effect • Can not stop formation of new deformity • Used in acute cases to relief inflammation & pain • Analgesic effect

  20. SUMMARY • DMARDs are used mainly in chronic cases of rheumatoid arthritis , when the disease is progresssing and forming deformity. • They do not remove the existing damage but prevent further formation of deformities. • They have no analgesic effect.

  21. SUMMARY ( Continue) • They are slow in onset needs weeks to manifest their effects . • Hydroxychloroquine acts mainly through suppression of the activity of lysosomalenzymez and trapping free radicals . • Its main adverse effects is irreversible retinal damage & hepatic toxicity.

  22. CONTINUE • Methotrexate acts mainly through suppression of phagocytic cells & T cells • Its adverse effects are bone marrow depression & mucosal ulceration • Infliximab is a chimeric TNF-α blocking agent. • Given with methotrexate to reduce antichimeric effect

  23. CONTINUE • Its main adverse effects are upper respiratory tract infections & reactivation of latent TB,

  24. CONTINUE • Methotrexate acts mainly through suppression of phagocytic cells &

More Related