Rheumatoid arthritis (RA) is an autoimmune disease that can cause joint pain and damage throughout your body. The joint damage that RA causes usually happens on both sides of the body. So, if a joint is affected in one of your arms or legs, the same joint in the other arm or leg will probably be affected, too.

1. RHEUMATOID ARTHRITIS
PRESENTED BY-
MOHD ASAD FAROOQI
FACULTY OF MAHARSHI COLLEGE OF PHARMACY .
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3. What Is Rheumatiod Arthritis ?
 RA, is a form of inflammatory arthritis and an autoimmune disease
 The immune system – is designed to protect our health by attacking foreign cells
such as viruses and bacteria – instead attacks the body’s own tissues, specifically
the synovium, a thin membrane that lines the joints. As a result of the attack, fluid
builds up in the joints, causing pain in the joints and inflamation that’s systemic –
meaning it can occur throughput body.

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4. Sign & symptoms
 joints may feel warm to the touch and decreased range of motion, as well as
inflammation,
 swelling and pain in the areas around the affected joints.
 Stiffness
 Malaises(feeling ill)
 Muscle aches
 Loss of appetite, which can lead to weight loss
 pain
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6. Non biologics
Immunosupressants– methotrexate
Sulfasalazine
Chloroquine
Leflunomide
Biologics
TNF inhibitors – infliximab, adalimumab
IL-1 antagonist – Anakinra
Others – prednisolone, gold salts
Drugs used in Rheumatoid arthritis.
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7. Drugs used in Rheumatoid arthritis.
 NSAIDs:(Nonsteroidal anti-inflammatorydrugs)
 NSAIDs include such drugs as ibuprofen, ketoprofen ,and naproxen sodium,celecoxib.
➢ The primary mechanism of action is inhibition of an enzyme called cyclooxygenase
(COX). COX is an enzyme that is required in the conversion of arachidonic acid to
prostaglandinH2 (PGH2) in the body.
➢ The prostaglandins that are formed from PGH2 are important mediators of sensations
such as pain and processes such as fever and inflammation.
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8. Disease-Modifying Antirheumatic drugs(DMARDs)
 hydroxycholorquine,sulfasalazine,leflunomide.
 Methotrexate also
 M/A
 The mode of action of Sulfasalazineor 5-aminosalicylic acid (5-
ASA) and sulfapyridine
 In ulcerative colitis, clinical studies utilizing rectal administration of
Sulfasalazine,SP and 5-ASA have indicated that the major therapeutic
action may reside in the 5- ASA moiety.
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9.  Corticosteroids–
 prednisone, prednisolone and methyprednisolone,
 M/A:
 Prednisoneis a glucocorticoid receptor agonist. It is first metabolized in the liver to
its active form, prednisolone. Prednisolonecrosses cell membranes and binds with
high affinity to specific cytoplasmic receptors.
 the result includes inhibition of leukocyte infiltration at the site of inflammation,
interference in the function of mediators of inflammatory response, suppression of
humoral immune responses, and reduction in edema or scar tissue.
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11.  Metabolic disorder – recurrent episodes of acute and
chronic arthritis
 Abnormal amounts of urates in the body
 Deposition of monosodium urate crystals in joints and
cartilages
 Hyperuricemia
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12. Acute gout:
 Sudden onset following rapid fluctuations in plasma uric
acid level
 Metatarsophalangeal joint of the great toe
 Tarsal joints, ankles, and knees
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13. 1. NSAIDs
2. Colchicine
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14. 1. NSAIDs
 Indomethacin, piroxicam, diclofenac, etoricoxib
 High and repeated doses
 Inhibit
urate crystal phagocytosis
Chemotactic migration of leukocytes
into the inflammed joints
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15. 2. Colchicine:
MOA: depolymerization of microtubules in granulocytes
granulocyte migration and phagocytosis Inhibits the
release of glycoprotein 
reduces inflammation and joint destruction
Antimitotic drug
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16.  Relieves acute attacks of gout
 Used for the prophylaxis of recurrent episodes of
gouty arthritis
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17. A. Uricosuric drugs: probenecid, sulfinpyrazone
B. Uric acid synthesis inhibitors : allopurinol
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18. Allopurinol
Xanthine
oxidase
Xanthine
oxidase
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19. ThankyouTHANK YOU
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