Anti Rheumatoid Drugs: By: Dr.reenu Bajpai

Anti rheumatoid Drugs By: Dr.Reenu Bajpai

Rheumatoid Arthritis What is it? Rheumatoid arthritis is a chronic disease, mainly characterized by inflammation of the lining, or synovium, of the joints. It can lead to long-term joint damage, resulting in chronic pain, loss of function and disability. RA is an autoimmune disease.

Rheumatoid arthritis (RA) progresses in three stages • The first stage is the swelling of the synovial lining, causing pain, warmth, stiffness, redness and swelling around the joint • Second is the rapid division and growth of cells, or pannus, which causes the synovium to thicken • In the third stage, the inflamed cells release enzymes that may digest bone and cartilage, often causing the involved joint to lose its shape and alignment, more pain, and loss of movement

Cont…. • It can affect any joint but is common in the wrist and fingers. • More women than men get rheumatoid arthritis. • It often starts between ages 25 and 55. • RA can affect body parts besides joints, such as your eyes, mouth and lungs. • No one knows what causes rheumatoid arthritis. Genes, environment and hormones might contribute. Treatments include medicine, lifestyle changes and surgery. These can slow or stop joint damage and reduce pain and swelling.

Drug Therapy The aim of drug therapy is . To ameliorate pain, swelling and joint pain . Prevent articular cartilage damage and bony erosions. . Prevent deformity and preserve joint function

Early diagnosed cases treated with NSAIDS But currently it is added with DMARDs (disease modifying antirheumatic drugs)

Drug prescribed: 1.DMARDs 2.Biologic response modifiers(BRMs) 3.Adjuvant drugs

DMARDs a.Immunosuppressants Drugs Methotrexate (MTx) : Neotrexate,Biotrexate Azathioprine : Imuran b.Sulfasalazine Salazo Pyrin c.Chloroquine and hydroxychloroquine d.Leflunomide Lefra e.Auranofin Ridaura ,Goldar

2.Biologic Response Modifiers These are recombinant protiens antibodies that bind and inhibit cytokines . a.TNF alpha inhibitors b.IL antagonist

3.Corticosteroids

Adverse effects of Immunosuppresents Oral ulceration GI upset Cirrhosis of liver

Contraindication of immunosuppressant Pregnency Breast Feeding Liver disease Leukopenia Peptic ulcer

Adverse effects of Chloroquine Skin Rashes Irritable Bowel Syndrome Neuropathy Myopathy

Adverse Effects of Lefunomide Headache Nausea Loss of hair Thrombocytopenia Cytopenia Leucopenia

Contraindication Pregnant women ,children , lactating women

Adverse effect of Auranofin Diarrhoea Abdominal cramps