antiarthritic drugs and skeletal muscle relaxants[NSAIDs,anti-inflamatory steroids and DMARDs]

Gold salts[sodium aurothiomalate and Auranofin]

sulfasalazine

penicillamine

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methotraxate

drug name

chloroquine

Chloroquine is primarily an antimalarial drug that is useful in rheumatoid arthritis

machanisim of action

indications

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machanism of action

it reduces the migration of leucocytes innto the tissues

inhibit the release of chemical mediators of inflamatoin

Gold is known to inhibit the proliferation of the lymphocytes

contraindications

it is largely unknown

side effects

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itching followed by rashes,which can progress to exfoliation

indications

storage

route of administration

sodium aurothiomalate is usualy given weekly by deep intramuscular injection.

auranofin is given orally.

renal damage-urine must be tested for protein at each visit

bone marrow suppression required weekly blood counts and patient should report bleeding and bruising.

stomatitis

dose-related diarrhoea with auranofin,which can be stopped by a high fiber diet.

Gold reduces swelling and treats the pain and stiffness.

disease progress in terms of joints and bone damage is slowed

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storage condition

route of administration

contraindications

nursing consideration

indications

mechanism of action

penicillamine is a chelating agent recormended for the removal of excess copper in patients with wwilsons disease.

penicillamine is used to treat Wilson's disease,cystituria, and patients with severe,active,rheumatoid arthritis who have failed to respond to an adequate trial of conventional therapy.

firmly it is esttablished as a second line drug and chemically it is an antagonist of folic acid and is cytotoxic.

mechanisim of action

it was originaly introduced for the treatment of cancer

it was also found to slow disease progression in rhuematic arthritis in terms of joint and bone damage.

indications

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nursing considerations

contraindications

side effects

treats the morning sickness and joint pain of rheumatic arthritis

treats the skin lessions of lupus erythematosus

it exert itts effects partly by blocking the production of one or more of the inflamatory mediators

and by interfering with the actions of leucocytes

it also inhibits the the proliferation of lymphocytes.

nursing consideration

contraindications

side effects

storage condition

route of administration

observe for ototoxins[tinitus,vertigo,changes in hearing ability.]

patient with maculopaty

headache,diarrhea,stomach pain,loss of appetite,hairloss,mood and mental changes

stored at room temparature(15-25 degres of celcius)

it is administered orally in the form of tablet or liquid

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indications

nursing consideration

contraindications

mechanisim of action

side effects

storage condition

route of admministration

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it must be given on empty starmach before meals atleast at one hour ortwo hours after meals.

use of penicillamine is contraindicated with pregnancy.

it must be kepted tightley closed

administered orally.

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storage condition

route of administration

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protect from light

products in powder form is stable for 6 months at room temparature when stored properly

upon resuspension, chloroquine should be stored at 4degres

chloroquine is contraindicated to patients with hearing loss,anemea and alcoholism

decrease field defect and porphyria.

lupus erythematosus

injection

observe for alergic reactions such as pluritis,rash,urticaria.

opthalmic tests requiredc in long term treatment

toxicity is a problem,observe for signs

mothers on therapy with penicillamine should not breastfeed their infants.

patients with a history of penicillamine-related aplastic aneamia.

notb given to pattients with evidence of renel insuficience.

side effects

cystinuria

fever

give patient pyridoxin daily as an supplement.