Antiarthritic Drugs Nursing Pharmacology Study Guide

Antiarthritic Drugs: Generic and Brand Names

Here is a table of commonly encountered immune system drugs, their generic names, and brand names:

Classification	Generic Name	Brand Name
Gold Compounds	auranofin	Ridaura
Gold Compounds	gold sodium thiomalate	Aurolate
Other Agents	anakinra	Kineret
	etanercept	Enbrel
	hyaluronidase derivatives	Synvisc
	penicillamine	Depen
	sodium hyaluronate	Hyalgan

Disease Spotlight: Arthritis

Arthritis is a group of more than 100 types of joint pain or disease and related conditions involving an inflammatory process in the joints which can cause pain and bone It affects people of all ages, sexes, and races. It is the leading cause of disability in America.
Symptoms include swelling, pain, stiffness, and decreased range of motion. Over time, this will lead to permanent joint changes.
NSAIDs are often used in rheumatoid arthritis (an autoimmune disorder affecting the small joints) and osteoarthritis (arthritis of the weight-bearing joints common in older people).

Gold Compounds

Gold salts treatment (chrysotherapy) is indicated for patients with rheumatic inflammatory conditions who do not respond to the usual anti-inflammatory therapies. Chrysotherapy involves macrophages taking up gold which then inhibit phagocytosis.

Therapeutic Action

The desired and beneficial action of gold compounds is:

Inhibition of phagocytosis and release of lysosomal enzymes leading to inhibited tissue destruction. This action allows gold salts to suppress and prevent some arthritis and synovitis.

Indications

Gold compounds are indicated for the following medical conditions:

Treatment for selected cases of rheumatoid and juvenile rheumatoid arthritis in patients whose disease have been unresponsive to standard therapy. However, they only prevent further damage and so are most effective if used early in the disease.
Auranofin is an oral agent for long-term therapy of rheumatic disorders.
Gold sodium thiomalate is an injected drug for early treatment of rheumatic disorders.

Pharmacokinetics

Here are the characteristic interactions of gold compounds and the body in terms of absorption, distribution, metabolism, and excretion:

Route	Onset	Peak	Duration
Oral	Slow	4-6 h	–
T1/2: 3-7 days Metabolism: – Excretion: urine and feces

Contraindications and Cautions

The following are contraindications and cautions for the use of gold compounds:

Any known allergy to gold
Severe diabetes
Congestive heart failure
Severe debilitation
Renal or hepatic impairment
Hypertension
Blood dyscrasias
Recent radiation treatment
History of toxic levels of heavy metals
Pregnancy or lactation

Adverse Effects

Use of gold compounds may result to these adverse effects:

Skin: dermatitis, pruritus, exfoliative dermatitis, allergic reactions ranging from flushing, fainting, and dizziness to anaphylactic shock
GI: stomatitis, glossitis, gingivitis, pharyngitis, laryngitis, colitis, diarrhea, other GI inflammation
Respiratory: gold bronchitis, interstitial pneumonitis
Hema: bone marrow depression
GU: vaginitis, nephrotic syndrome

Interactions

The following are drug-drug interactions involved in the use of gold compounds:

Penicillamine, antimalarials, cytotoxic drugs, immunosuppressive agents: potential for severe toxicity

Nursing Considerations

Nursing considerations for patients receiving antiarthritics are similar to those for patients receiving nonsteroidal anti-inflammatory drugs and related agents.

Practice Quiz: Antiarthritic Agents

Here are some practice questions for this study guide. Please visit our nursing test bank page for more NCLEX practice questions.

1. How can antiarthritic drugs suppress some arthritis?

References and Sources

References and sources for this pharmacology guide for Antiarthritic Drugs:

Karch, A. M., & Karch. (2011). Focus on nursing pharmacology. Wolters Kluwer Health/Lippincott Williams & Wilkins. [Link]
Katzung, B. G. (2017). Basic and clinical pharmacology. McGraw-Hill Education.
Lehne, R. A., Moore, L. A., Crosby, L. J., & Hamilton, D. B. (2004). Pharmacology for nursing care.
Smeltzer, S. C., & Bare, B. G. (1992). Brunner & Suddarth’s textbook of medical-surgical nursing. Philadelphia: JB Lippincott.

Antiarthritic Drugs