Comprehensive Nursing Pharmacology Q 179
Antirheumatics are used to:
A. Retard progression of joint deterioration.
B. Encourage excretion of autoantibodies.
C. Directly affect the inflammatory response.
D. Mediate the action of NSAIDs.
Correct Answer: A. Retard progression of joint deterioration
These drugs cannot stop the disease itself but are believed to retard or prevent the process of joint deterioration. Antirheumatics include drugs, which are used to treat the symptoms of rheumatoid arthritis and those that can modify the course of the disease. The drugs that help treat symptoms such as pain and inflammation are aspirin, non-steroidal anti-inflammatory drugs (NSAIDs), and steroids.
Option B: Autoantibodies are not excreted. Biologics, on the other hand, are very selective in their mechanism of action. The overarching functions of biologics include (1) interfering with cytokine function or production, (2) inhibiting the “second signal” required for T-cell activation, or (3) depleting B-cells or inhibiting factors that active B-cells. Tofacitinib is a small molecule inhibitor of JAK, a protein tyrosine kinase involved in mediating cytokine.
Option C: The inflammatory process is affected indirectly. Drugs that can slow the progression of rheumatoid arthritis and help with pain, inflammation, and stiffness are called disease-modifying rheumatoid arthritis drugs (DMARDs).
Option D: Disease-modifying antirheumatic drugs are used in combination with NSAIDs but do not mediate their effect. Each DMARD has a unique mechanism of action ultimately interfering with critical pathways in the inflammatory cascade. Methotrexate, for example, stimulates adenosine release from fibroblasts, reduces neutrophil adhesion, inhibits leukotriene B4 synthesis by neutrophils, inhibits local IL-1 production, reduces levels of IL-6 and IL-8, suppresses cell-mediated immunity, and inhibits synovial collagenase gene expression.