Pharmacology

 A 50 year old woman has had rheumatoid arthritis for 3 years and has been taking multiple NSAID’s. She has taken corticosteroids a few times during flare ups. The disease seems to be progressing with stiffness and swelling in her hands and wrists. Examination reveals rheumatoid nodules, synovitis of both wrists and metacarpo-phalangeal joints. This is an indication of an acute exacerbation of rheumatoid arthritis. She is prescribed methotrexate with sulfasalazine and a short course of prednisone. Assignment Questions 1. What is the mechanism of action of prednisone? 2. What is the concern with chronic treatment with glucocorticoids? 3. What is the mechanism of action of methotrexate and sulfasalazine. 4. What are the side effects of methotrexate and sulfasalazine