DMARDs

Generic Name Brand Name MOA Side Effects Notes

Methorexate Oxtrexup Inhibits folate synthesis GI
Rasuvo (Decrease DNA synthesis in inflammatory Hematologic
RediTrex cells) Hepatic
Antineoplastic Pulmonary related
Immunomodulating properties reactions

Auranofin (PO) Ridaura Hematologic -No longer used because of

Dermatologic toxicity and newer DMARDs are
Anti-mitochondrial activity GI available with better efficacy
Aurothiomalate Myocrisin
Gold compounds Cell apoptosis Rena side effects
(IM)
Hypotension
Aurothioglucose Solganal Flushing
(IV)

Active metabolite inhibits enzymes for Diarrhea -Contraindicated during

pyrimidine synthesis, thereby prevents Alopecia pregnancy
Leflunomide Arava replication of DNA and synthesis of RNA Hepatoxicity
and proteins in immune cells

Etanercerpt Enbrel Susceptibility to

Adalimumab Amgevita infectious disease
Hyrimoz TNF-a blockers
Biologic Agents/ Idacio
Immunodulators
Golilumab Simponi
Certolizumab Cimzia
Infliximab Remicade
Hydroxychloroquine Plaquenil Reduces the chemotaxis and phagocytic
activity of immune cells

Sulfasalazine Azulfidine Its active metabolite, Sulfapyridine, has

unknown mechanism

Penicillamine Cuprimine Reduces blood levels of inflammatory

Depen cytokines
 Acute Gout/ Acute Gouty Attacks
Generic Name Brand Name MOA Side Effects Notes
Colchicine Colcrys Inhibits mictrotubule synthesis and motility Diarrhea
Gloperba of inflammatory cells when urate crystal Neuropathis
Mitigane induces joint inflammation

Analgesics
(NSAIDS)
Steroids

Chronic Tophaceous Gout

Generic Name Brand Name MOA Side Effects Notes
Colchicine Colcrys Inhibits mictrotubule synthesis and motility Diarrhea -if patient presents acute gout
Gloperba of inflammatory cells when urate crystal Neuropathis attack
Mitigane induces joint inflammation

Hypouricemic -Cannot be the initial treatment

Therapy because sudden changes in serum
uric acid levels precipitate acute
attacks of gout
-Stabilizes uric acid levels
-Prevent acute gout attack
-Usually initiated after 2-3 weeks
of colchicine therapy/ (After
acute attack)
Allopurinol Inhibits Xanthine Oxidase N&V -Active metabolite: Oxypurinol
Hepatitis -Reduces blood uric acid levels
Skin Rashes -Prevent the progression of gouty
arthritis
Febuxostat Inhibit Xanthine Oxidase -OD administration
-Greater efficacy than
Allopurinol
 Generic Name Brand Name MOA Side Effects Notes

Probenecid -Induce loss of uric acid in the

Competitively inhibits the reabsorption of Formation of renal uric urine
Uricosuric Agents uric acid in the kidneys acid stones
Sulfinpyrazone

Catabolic Enzyme Pegloticase Recombinant uricase enzymes which

Preparations catalyzes the oxidation of uric acid to
Allantoin, an inert, water-soluble purine
Rasburicase metabolite readily eliminated by renal
excretion