Comprehensive Nursing Pharmacology Q 191
Which of the following agents can be used in the treatment of rheumatoid arthritis, Sjögren’s syndrome, and SLE?
A. auranofin (Ridaura)
B. allopurinol (Zyloprim)
C. sulfasalazine (Azulfidine)
D. chloroquine (Aralen)
Correct Answer: D. chloroquine (Aralen)
Chloroquine has had documented success in the treatment of rheumatoid arthritis, Sjögren’s syndrome, and SLE. Auranofin and sulfasalazine are used in the treatment of rheumatoid arthritis, but none are used in the treatment of all three syndromes. Non-FDA approved indications of chloroquine include the treatment of certain autoimmune diseases, such as rheumatoid arthritis and systemic lupus erythematosus. Also, current research suggests that chloroquine may be helpful as an antitumor medication for the treatment of cancer in association with chemotherapy and radiation
Option A: This medication is used as part of a complete treatment program including non-drug therapies (e.g., rest, physical therapy) to treat active rheumatoid arthritis. It is used to treat patients with severe rheumatoid arthritis who have not responded to or cannot take other medications. Auranofin is a gold compound.
Option B: Allopurinol, a xanthine oxidase inhibitor, is a urate-lowering medication. Allopurinol undergoes metabolism in the liver, where it transforms into its pharmacologically active metabolite, oxypurinol. The half-life of allopurinol is 1 to 2 hours, and oxypurinol is about 15 hours. Both allopurinol and oxypurinol are renally excreted. Allopurinol and oxypurinol both inhibit xanthine oxidase, an enzyme in the purine catabolism pathway that converts hypoxanthine to xanthine to uric acid.
Option C: Sulfasalazine is indicated for the treatment of chronic inflammatory diseases such as rheumatoid arthritis in children and adults and ulcerative colitis. It also has off-label uses in treating patients with ankylosing spondylitis, mild to moderately active Crohn’s disease, psoriasis, and psoriatic arthritis.