Classification of Anti Rheumatoid Drugs - Pharmacology

📌 𝐅𝐨𝐥𝐥𝐨𝐰 𝐨𝐧 𝐈𝐧𝐬𝐭𝐚𝐠𝐫𝐚𝐦:- https://www.instagram.com/drgbhanuprakash
📌𝗝𝗼𝗶𝗻 𝗢𝘂𝗿 𝗧𝗲𝗹𝗲𝗴𝗿𝗮𝗺 𝗖𝗵𝗮𝗻𝗻𝗲𝗹 𝗛𝗲𝗿𝗲:- https://t.me/bhanuprakashdr
📌𝗦𝘂𝗯𝘀𝗰𝗿𝗶𝗯𝗲 𝗧𝗼 𝗠𝘆 𝗠𝗮𝗶𝗹𝗶𝗻𝗴 𝗟𝗶𝘀𝘁:- https://linktr.ee/DrGBhanuprakash

Classification of Anti Rheumatoid Drugs - Pharmacology

Rheumatoid arthritis (RA) is an inflammatory autoimmune disorder characterized by joint pain, swelling, and synovial destruction. RA predominantly affects middle-aged women. The condition can also cause various extra-articular manifestations such as rheumatoid nodules and pulmonary fibrosis. Diagnosis is mainly based on clinical features (e.g., morning stiffness, symmetrical joint swelling) and laboratory tests (e.g., anti-CCP). X-ray findings (e.g., soft tissue swelling or joint space narrowing) occur late in the disease and are therefore not typically used for diagnosis. Early intervention with disease-modifying antirheumatic drugs (DMARDs) plays a decisive role in successful treatment. RA is not curable, but early effective treatment may help offset severe complications (e.g., permanent damage to the affected joints).

General measures
-----------------------------
For acute episodes of inflammation: cryotherapy
Physical and occupational therapy
Physical activity

Acute anti-inflammatory therapy
----------------------------------------------------
Indication: acute attack

Glucocorticoids: given until DMARD's onset of action or as long-term therapy for highly active RA.
Systemic
Intra-articular injections of PRN
Prevention of osteoporosis: optimization of sufficient calcium and vitamin D intake

NSAIDs and COX-2 inhibitors: symptomatic relief without improving prognosis
PPIs are recommended because combining glucocorticoids with NSAIDs substantially increases the risk of GI ulcers.

Long-term anti-inflammatory therapy with disease-modifying antirheumatic drugs (DMARDs)
----------------------------------------------------------------------------------------------------------------------------------------------------
Induce immunosuppression, leading to potential remission of RA
Reduce mortality and morbidity by up to 30%
Slow progression of disease
Preserve joint function
Limit complications
Slow onset of action (≥ 6 weeks), so symptomatic treatment with glucocorticoids and NSAIDs is often required

Non-biologic agents
---------------------------------
Drug of choice: methotrexate (MTX)
First-line treatment for moderate to severe RA
Benefits: highly effective, relatively well-tolerated, low cost, possibly life-prolonging
Gastrointestinal side effects , rash, hepatotoxicity (abnormal liver chemistry), interstitial pneumonitis and pulmonary fibrosis, bone marrow suppression , nephrotoxicity, increased risk of lymphoproliferative disorders, teratogenicity, alopecia
To minimize side effects, folic acid is recommended 24–48 hours after taking MTX.
Do not give NSAIDs on the same day as MTX, as they can worsen the side effects of MTX by inhibiting its renal excretion .

Alternative drugs:
Leflunomide
Hydroxychloroquine
Sulfasalazine: for use in pregnancy

Biologic therapy
--------------------------
Indication: moderate or severe disease activity remaining after three months of DMARD therapy
Should be combined with non-biologic DMARDs
Tumor necrosis factor (TNF) α inhibitors: e.g., adalimumab, infliximab, etanercept
See contraindications to anti-TNF-α treatment.
Others: rituximab (anti-CD20) and anakinra (interleukin-1 receptor antagonist, particularly for Still disease)

Early administration of DMARDs is crucial for a better outcome!

#ClassificationofAntiRheumatoidDrugs #AntiRheumatoidDrugs #pharmacology #usmle #neetpg #mbbs #fmge

Видео Classification of Anti Rheumatoid Drugs - Pharmacology канала Dr.G Bhanu Prakash Animated Medical Videos