Paper I
2024 December (Supplementary) (2019 Scheme) · 100 marks · 180 min

Question

Name three drug groups with two examples each used in treatment of Rheumatoid arthritis. Briefly describe DMARD (3+3)

Q66 marksShort Essays

Answer

Three drug groups for rheumatoid arthritis, two examples each

GroupExamples
NSAIDsIbuprofen, Naproxen
DMARDsMethotrexate, Hydroxychloroquine
Biologic agentsEtanercept, Infliximab (TNF-alpha inhibitors)

Note on DMARDs Disease-modifying antirheumatic drugs slow or halt the progressive joint damage of rheumatoid arthritis, unlike NSAIDs, which only control symptoms without altering disease course. Methotrexate, the anchor drug, is thought to act substantially through increased release of anti-inflammatory adenosine at the low weekly doses used, alongside its folate-antagonist effect reducing lymphocyte proliferation. DMARDs have a slow onset of benefit (weeks to months), so are typically started early and often bridged with NSAIDs/corticosteroids for symptom control until effect is established. Regular monitoring (blood counts, liver function) is required given their immunosuppressive/cytotoxic mechanisms.

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