Inhibits protein synthesis in susceptible organisms by inhibiting DNA and RNA polymerase. Onset 2-4 months, Gold standard for SLE can be used for RA
Hydroxychloroquine (Plaquenil)
Interferes w/folic acid metabolism, Death of rapidly replicating cells, particularly malignant ones, and immunosuppression. Gold standard for RA
Methotrexate( Rheumatrex)
Inhibits prostaglandin synthesis, decreased pain and inflammation, reduces fever
NSAIDS
Depression, insomnia, migraine, nausea, diarrhea, infusion reactions, fever, DMARDs, monoclonal antibodies
Belimumab (Benlysta)
Bind to Ca++ and prevent stones in lower urinary tract
Potassium Citrate
Locally acting anti inflammatory action in the colon, where activity is probably a result of inhibition of prostaglandin synthesis. Reductions of sx of ulcerative colitis or RA
Sulfasalazine (Azulfidine)
Class of Diclofenac (voltaren), Ibuprofen (Motrin), Indomethacin (Indocin), Nabumetone (Relafen), Oxaprozin (DayPro), Celecoxib (Celebrex)
NSAIDS
Antipyrectics,antirheumatics, analgesics,
headache, rhinitis, URI, injection site reaction TNF blocking agent, antirheumatic
Etanercept (Enbrel)
Help kidney reabsorb more ca++, then there is less ca++ in the urine
Thiazide diuretic
Neutralizes and prevents the action of tumor necrosis factor (TNF), resulting in anti inflammatory and antiproliferative activity
Adalimumab (Humira)
Infliximab (Remicade)
Etanercept (Enbrel)
Inhibits synthesis of prostaglandins that may serve as mediators of pain and fever, primality in the CNS, Analgesia, Antipyretics
Acetaminophen( Tylenol)
Fever, headache, n/v/d, anorexia, rash, angioedema
an antirhuematic, GI anti inflammatory
Sulfasalazine (Azulfidine)
Rx as Delaudid for renal colic
Hydromorphone
Inhibits T and B cell activity, suppresses synovitis during active stage of rheumatoid disease slow acting 3-6 months, antirheumatics
Minor DMARDs, Gold-containing compounds
Aurothioglucose (Solganol)
Gold sodium thiomalate (Myochrysine)
Inhibits platelet aggregation, produces analgesic and reduce inflammation and fever , Salicylates
Aspirin
used prophylactically
Antibiotics
RA/SLE/Both, suppress inflammation and the normal immune response. Used for the shortest duration and at lowest dose possible to minimize adverse effects. Fast acting-onset in days
Glucocorticoids/Adrenal Corticosteroids:
Prednisone, Hydrocortisone sodium succinate, Methylprednisolone sodium succinate, Methylprednisolone acetate
Mainly for SLE, can be used for RA, antimalarials, antirheumatic
Hydroxychloroquine (Plaquenil)
Most important intervention
Adequate fluid intake