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Medicine

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Rheumatology

Question
28 out of 30
 

Rituximab (Anti-CD20 antibody) is used in all except? (AIIMS May 2008)



A SLE
B RA
C PNH
D NHL

Ans. C PNH (Ref. H - 17th, Pg. 2090, Katzung Pharmacology, 9th ed. Section VI. Chapter 36)

a. It is a monoclonal antibody. b. It works by attaching to (B cells) and killing them.

c. It is an anti-CD20 antibody.

d. That also has clinical activity CLL, NHL (relapsed or refractory low-grade or follicular B cell non-Hodgkin's lymphoma.) and Ca colon.

5. Abatacept: It is a fusion protein. (It is a new drug)

6. Gene therapy - Genes which intercept the pathway of inflammatory cascade reaction are used.

7. Surgery - Synovectomy, tenosynovectomy, arthroplasty and total joint replacements.

Extra Edge: Recent Advances (TNF alpha nutrilizing drugs) (Ref: H-18th edition, Pg-2749)

a. Adalimumab b. Golimumab c. Etanercept

Anti-TNF agents should be avoided in patients with active infection or a history of hypersensitivity to these agents. A major concern is the increased risk for infection, especially opportunistic fungal infection and reactivation of latent tuberculosis.

Tocilizumab

Tocilizumab is a humanized monoclonal antibody directed against the membrane and soluble forms of the IL-6 receptor. IL-6 is a proinflammatory cytokine implicated in the pathogenesis of RA, with detrimental effects on both joint inflammation and damage.

Recent Advances

New Drugs

1. Etodolacis a chiral NSAID, for the treatment of rheumatoid arthritis.

2. Licofelone: Dual inhibitors that block both cyclooxygenase (COX) and lipoxygenase (LOX) metabolic pathways of arachidonic acid. It has analgesic, anti-inflammatory, and antiasthmatic effects at doses that cause no GI side effects.

3. Flupirtine:

It is a selective neuronal potassium channel opener that also has NMDA receptor antagonist properties. Flupirtine is a non-opioid, non-NSAID, non-steroidal, analgesic

All these are new drug not give in Harrison’s 18th Edition also.

4. Tramadol a centrally acting analgesic inhibits serotonin reuptake and inhibits norepinephrine reuptake, enhancing inhibitory effects on pain transmission in the spinal cord.

Rheumatology Flashcard List

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