ERMD Block 3 Pharm

"Ibuprofen — MOA"

"• Reversibly inhibits COX-1 and COX-2

• Decreases prostaglandin synthesis"

"Ibuprofen — Uses"

"• Pain and inflammation in osteoarthritis and rheumatoid arthritis

• Musculoskeletal pain

• Gout flares"

"Ibuprofen — Side Effects"

"• GI irritation, ulcer, and bleeding

• Renal toxicity

• Increased cardiovascular thrombotic risk"

"Naproxen — MOA"

"• Reversibly inhibits COX-1 and COX-2

• Decreases inflammatory prostaglandins"

"Naproxen — Uses"

"• Osteoarthritis and rheumatoid arthritis

• Pain from gout flares"

"Naproxen — Side Effects"

"• GI ulcer/bleeding

• Renal toxicity

• Increased cardiovascular thrombotic events"

"Meloxicam — MOA"

"• Preferential COX-2 inhibitor

• Decreases prostaglandin synthesis at sites of inflammation"

"Meloxicam — Uses"

"• Pain and inflammation in osteoarthritis and rheumatoid arthritis"

"Meloxicam — Side Effects"

"• Increased cardiovascular risk

• GI effects (less than nonselective NSAIDs)

• Renal toxicity"

"Diclofenac — MOA"

"• Nonselective COX inhibitor

• Decreases prostaglandin synthesis"

"Diclofenac — Uses"

"• Topical treatment of osteoarthritis pain to limit systemic toxicity"

"Diclofenac — Side Effects"

"• GI bleeding and ulceration

• Renal toxicity

• Increased cardiovascular risk"

"Aspirin — MOA"

"• Irreversibly inhibits COX-1 in platelets

• Decreases thromboxane A₂ production"

"Aspirin — Uses"

"• Rarely used as anti-inflammatory in OA

• Primarily used at low doses as antiplatelet therapy"

"Aspirin — Side Effects"

"• GI irritation and bleeding

• Ulcer formation

• Increased toxicity risk in elderly"

"Celecoxib — MOA"

"• Selective COX-2 inhibitor

• Decreases inflammatory prostaglandin synthesis"

"Celecoxib — Uses"

"• Pain and inflammation in osteoarthritis and other arthritides

• Preferred when GI risk is high with nonselective NSAIDs"

"Celecoxib — Side Effects"

"• Serious cardiovascular thrombotic events

• Renal impairment"

"Capsaicin — MOA"

"• Activates TRPV1 receptors on nociceptive fibers

• Chronic exposure leads to defunctionalization and decreased pain signaling"

"Capsaicin — Uses"

"• Mild osteoarthritis pain

• Neuropathic pain conditions"

"Capsaicin — Side Effects"

"• Localized burning, stinging, and erythema"

"Duloxetine — MOA"

"• Serotonin-norepinephrine reuptake inhibitor (SNRI)

• Enhances descending inhibitory pain pathways"

"Duloxetine — Uses"

"• Chronic musculoskeletal and osteoarthritis pain when NSAIDs are not suitable

• Neuropathic pain

• Depression and anxiety"

"Duloxetine — Side Effects"

"• GI upset (nausea, constipation)

• Sexual dysfunction

• CNS effects and risk of serotonin syndrome"

"Methylprednisolone — MOA"

"• Glucocorticoid receptor agonist

• Alters gene transcription to reduce inflammatory mediators"

"Methylprednisolone — Uses"

"• Intra-articular injections for moderate to severe osteoarthritis pain and other joint inflammation"

"Methylprednisolone — Side Effects"

"• Potential cartilage damage with repeated injections

• Systemic glucocorticoid adverse effects if absorbed in significant amounts"

"Triamcinolone — MOA"

"• Glucocorticoid receptor agonist

• Decreases cytokine production and inflammation"

"Triamcinolone — Uses"

"• Intra-articular injections for osteoarthritis and other inflammatory arthritides"

"Triamcinolone — Side Effects"

"• Risk of joint damage with frequent injections

• Systemic steroid effects with excessive absorption"

"Indomethacin — MOA"

"• Potent reversible COX-1 and COX-2 inhibitor

• Decreases prostaglandin-mediated inflammation"

"Indomethacin — Uses"

"• Acute gout flares

• Sometimes used for other acute inflammatory conditions"

"Indomethacin — Side Effects"

"• Severe GI toxicity (ulcers, bleeding)

• Renal impairment

• CNS effects, especially in elderly"

"Colchicine — MOA"

"• Inhibits microtubule polymerization

• Impairs neutrophil migration and inflammatory response in joints"

"Colchicine — Uses"

"• Acute gout attacks when NSAIDs are contraindicated or ineffective

• Prophylaxis between gout flares"

"Colchicine — Side Effects"

"• GI distress (nausea, vomiting, diarrhea)

• Myopathy and neuropathy, especially with renal impairment

• Blood dyscrasias"

"Allopurinol — MOA"

"• Inhibits xanthine oxidase

• Reduces production of uric acid"

"Allopurinol — Uses"

"• First-line urate-lowering therapy for chronic gout prevention"

"Allopurinol — Side Effects"

"• Rash and pruritus

• Risk of severe cutaneous adverse reactions (SCARs), especially in HLA-B*5801 carriers

• Rare leukopenia and hepatotoxicity"

"Febuxostat — MOA"

"• Non-purine xanthine oxidase inhibitor

• Decreases uric acid production"

"Febuxostat — Uses"

"• Chronic gout prevention in patients intolerant of or not responding to allopurinol"

"Febuxostat — Side Effects"

"• Elevated liver function tests

• Increased risk of cardiovascular events and mortality"

"Probenecid — MOA"

"• Uricosuric agent

• Inhibits renal tubular reabsorption of uric acid to increase its excretion"

"Probenecid — Uses"

"• Chronic gout management in patients who under-excrete uric acid and have adequate renal function"

"Probenecid — Side Effects"

"• Precipitation of uric acid kidney stones

• Rash and GI irritation

• Ineffective in significant renal insufficiency"

"Pegloticase — MOA"

"• Recombinant pegylated uricase

• Oxidizes uric acid to allantoin, a more soluble metabolite"

"Pegloticase — Uses"

"• Severe, treatment-refractory chronic gout"

"Pegloticase — Side Effects"

"• Infusion reactions and anaphylaxis

• Development of anti-drug antibodies leading to loss of efficacy and gout flares"

"Methotrexate — MOA"

"• Inhibits dihydrofolate reductase (DHFR)

• Decreases nucleotide synthesis and proliferation of immune cells"

"Methotrexate — Uses"

"• First-line conventional synthetic DMARD for rheumatoid arthritis

• Also used in psoriasis and some malignancies"

"Methotrexate — Side Effects"

"• GI upset and stomatitis

• Hepatotoxicity and elevated liver enzymes

• Bone marrow suppression and infection risk

• Pulmonary toxicity

• Toxicity reduced with folate supplementation"

"Hydroxychloroquine — MOA"

"• Modulates immune activity

• May suppress T-lymphocyte function and leukocyte chemotaxis"

"Hydroxychloroquine — Uses"

"• Rheumatoid arthritis

• Systemic lupus erythematosus

• Sjogren's syndrome

• Antimalarial treatment"

"Hydroxychloroquine — Side Effects"

"• Retinal toxicity with prolonged or high-dose therapy

• GI upset

• Rare myopathy and cardiomyopathy"

"Abatacept — MOA"

"• Fusion protein that inhibits T-cell costimulation

• Binds CD80/86 to block CD28-mediated activation"

"Abatacept — Uses"

"• Moderate to severe rheumatoid arthritis refractory to conventional DMARDs"

"Abatacept — Side Effects"

"• Increased risk of serious infections

• Possible COPD exacerbations"

"Rituximab — MOA"

"• Chimeric monoclonal antibody against CD20

• Depletes B lymphocytes"

"Rituximab — Uses"

"• Rheumatoid arthritis

• Certain B-cell lymphomas and leukemias"

"Rituximab — Side Effects"

"• Infusion reactions

• Hepatitis B reactivation

• Progressive multifocal leukoencephalopathy (PML)

• Neutropenia"

"Infliximab — MOA"

"• Chimeric monoclonal antibody against TNF-α

• Neutralizes TNF-α activity"

"Infliximab — Uses"

"• Rheumatoid arthritis and other autoimmune inflammatory diseases"

"Infliximab — Side Effects"

"• Serious infections including TB reactivation

• Increased risk of malignancy

• Worsening heart failure"

"Etanercept — MOA"

"• Recombinant TNF receptor fusion protein

• Binds TNF-α and prevents receptor interaction"

"Etanercept — Uses"

"• Rheumatoid arthritis and various inflammatory arthritides"

"Etanercept — Side Effects"

"• Increased risk of serious infections

• Malignancy risk

• Possible demyelinating disease and heart failure exacerbation"

"Tocilizumab — MOA"

"• Monoclonal antibody against IL-6 receptor

• Blocks IL-6-mediated inflammatory signaling"

"Tocilizumab — Uses"

"• Moderate to severe rheumatoid arthritis after inadequate response to other DMARDs"

"Tocilizumab — Side Effects"

"• Serious infections

• Elevated liver enzymes and lipids

• Hypertension

• Increased risk of GI perforations"

"Tofacitinib — MOA"

"• Oral Janus kinase (JAK) inhibitor

• Reduces signaling of multiple cytokines"

"Tofacitinib — Uses"

"• Moderate to severe rheumatoid arthritis as a targeted synthetic DMARD"

"Tofacitinib — Side Effects"

"• Serious infections

• Thrombosis and major adverse cardiovascular events

• Malignancy risk"

"Betamethasone — MOA"

"• High-potency topical glucocorticoid

• Binds glucocorticoid receptors to reduce inflammation and proliferation"

"Betamethasone — Uses"

"• Psoriasis

• Atopic dermatitis and other inflammatory skin diseases"

"Betamethasone — Side Effects"

"• Skin atrophy and striae

• Folliculitis and perioral dermatitis

• Higher risk with prolonged or high-potency use"

"Calcipotriene — MOA"

"• Vitamin D analog

• Inhibits keratinocyte proliferation and promotes differentiation"

"Calcipotriene — Uses"

"• Topical treatment of psoriasis

• Often combined with topical corticosteroids or retinoids"

"Calcipotriene — Side Effects"

"• Local irritation

• Minimal risk of hypercalcemia with topical use"

"Calcitriol — MOA"

"• Active form of vitamin D3

• Inhibits keratinocyte and T-cell proliferation"

"Calcitriol — Uses"

"• Topical treatment of psoriasis"

"Calcitriol — Side Effects"

"• Minimal adverse effects with topical administration"

"Tazarotene — MOA"

"• Topical retinoid that binds retinoic acid receptors (RARs)

• Modulates gene expression and decreases epidermal hyperproliferation"

"Tazarotene — Uses"

"• Psoriasis

• Acne

• Photoaging"

"Tazarotene — Side Effects"

"• Skin irritation and erythema

• Photosensitivity

• Teratogenic, especially if applied to large body surface area"

"Acitretin — MOA"

"• Oral retinoid

• Normalizes epidermal differentiation and reduces hyperkeratosis"

"Acitretin — Uses"

"• Severe, recalcitrant psoriasis"

"Acitretin — Side Effects"

"• Hypertriglyceridemia

• Hepatotoxicity

• Mucocutaneous dryness (cheilitis, xerosis)

• Highly teratogenic with pregnancy avoidance required for 3 years after discontinuation"

"Apremilast — MOA"

"• Phosphodiesterase-4 (PDE4) inhibitor

• Increases cAMP and reduces expression of inflammatory cytokines such as TNF-α and IL-23"

"Apremilast — Uses"

"• Moderate to severe psoriasis and psoriatic arthritis"

"Apremilast — Side Effects"

"• Weight loss

• Diarrhea, especially at initiation

• Depression and mood changes"

"Cyclosporine — MOA"

"• Calcineurin inhibitor

• Binds cyclophilin and blocks IL-2 transcription, reducing T-cell activation"

"Cyclosporine — Uses"

"• Severe psoriasis when other treatments fail

• Transplant immunosuppression"

"Cyclosporine — Side Effects"

"• Nephrotoxicity

• Hypertension

• Increased risk of malignancy and infections"

"Adalimumab — MOA"

"• Fully human monoclonal antibody against TNF-α

• Neutralizes TNF-α to reduce inflammation"

"Adalimumab — Uses"

"• Moderate to severe psoriasis

• Rheumatoid arthritis and other autoimmune inflammatory diseases"

"Adalimumab — Side Effects"

"• Serious infections including TB reactivation

• Malignancy risk

• Injection-site reactions"

"Ustekinumab — MOA"

"• Monoclonal antibody against IL-12 and IL-23

• Reduces Th1 and Th17-mediated inflammation"

"Ustekinumab — Uses"

"• Moderate to severe psoriasis

• Psoriatic arthritis"

"Ustekinumab — Side Effects"

"• Mildly increased risk of infections

• Generally well tolerated"

"Secukinumab — MOA"

"• Monoclonal antibody against IL-17A

• Reduces keratinocyte activation and inflammation"