Disease-Modifying Drugs for Rheumatoid Arthritis

by Tirupura Teagarajan

1.      Aspirin is used with…

(a)  Myalgia 

(b)  Fever 

(c)   Peptic ulcer 

(d)  Rheumatoid Arthritis (RA) 

(e)  Unstable angina 

2.      Methotrexate reduces inflammation by…

(a)  Inhibiting cytokine production 

(b)  Inhibiting pyrimidine biosynthesis 

(c)   Inhibiting purine synthesis 

(d)  Inhibiting phospholipase A₂ 

(e)  Stimulating release of adenosine 

3.      Leflunomide…

(a)  Inhibits action of dihydroorotate dehydrogenase 

(b)  Poorly absorbed orally 

(c)   More than 90% is bound to albumin 

(d)  Active metabolite undergoes biliary recycling, the rest of the metabolites are excreted renally 

(e)  Adverse effects: Headache, diarrhea, nausea, weight loss, flu-like symptoms 

4.      TNF inhibitors are

(a)  Adalimumab 

(b)  Celecoxib 

(c)   Etanercept 

(d)  Infliximab 

(e)  Anakinra 

5.      Mechanism of Action

(a)  Methotrexate inhibits dihydrofolate reductase (DHFR) 

(b)  Leflunomide increases orotate synthesis 

(c)   Hydroxychloroquine inhibits phospholipase A₂ and platelet aggregation 

(d)  Gold salts suppresses phagocytosis and lysosomal enzyme activity 

(e)  Etanercept inhibits TNF-α by binding three molecules together 

(f)    Anakinra binds to TNF-α and inhibits its actions 

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