Integrated Medicinal Chemistry and Pharmacology II - Winter Quarter

Reading Assignment and General Outline

Subject covered in this section: Disease Modifying Anti-Rheumatic Drugs (DMARDs)
 It is very important that you know and understand the different sub-classes of DMARD
drugs that are used and how they target the immune system because this underlies when/
why/ or how they can be combined to treat the patients underlying inflammatory condition.
 Additionally, it is important to recognize class type adverse effects as well as drug specific
adverse effects, especially when they are serious, are life threatening, or impair quality of
life. Similarly, drug-drug interactions that can lead to significant adverse effects are also
critical for you to recognize, understand how they occur, and grasp their importance.
 Patients will respond differently to these agents as one drug regimen does not work for
every situation or every patient. Some drugs are better in treating certain conditions but
may cause adverse effects so everything needs to be considered when determining what is
best for the patient. In particular, which set of DMARDs are acceptable to use in a mother
during pregnancy or expecting to get pregnant, is a very good talking point.
 Use your attention to detail and critical thinking skills.
 The tables in the textbooks are useful. Look over them and try to discern which ones are
most important for you to know at this point in time. We will discuss this during lecture.
 I will post the basics of clinical guidelines that will help in terms of seeing how these drugs
are combined in clinical practice.
 Recommend to work through the Pharmacology Case File in AccessPharmacy – Case #30
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Katzung (14th ed.) Ch. 36 – Anti-rheumatic Drugs, non-opioid analgesics /Drugs Used in Gout
 Figures: DMARDs: 36-4
 Pages: 649 – 658: Disease Modifying Anti-rheumatic Drugs (DMARDs)
o If you struggled with immunology; review the APC and T-cell interactions as
several drugs that will be covered in the next two quarters have MOA’s that act at
these biological targets.
o Synthetic molecules: methotrexate, hydroxychloroquine, tofacitinib, etc.
o Biological agents: adalimumab, abatacept, tocilizumab, anakinra, etc.

Foye’s (8th ed.) Chapter 5 – Principles of Biotechnology-derived Drugs: Pharmacogenomics

 Pages: 175-179 and Figure 5.22 (specific: 6-mercaptopurine)

Chapter 15 – Drugs Used to Treat Pain-Peripherally Acting Agents

 Figures – DMARDS: 15.32, 15.33, 15.34, 15.35, 15.36, 15.36
 Pages: 580 – 589: Disease Modifying Anti-rheumatic Drugs (DMARDs)
o Page: 580 – 582: background, MOA, ADEs, SAR
o Pages: 582 - 586: aminoquinolines and other synthetic small molecules;
methotrexate, hydroxychloroquine, tofacitinib, etc.
o Pages: 586 - 589: Biologic DMARDs; adalimumab, abatacept, tocilizumab,
anakinra, etc.

PSC6311 – iMCP-2 Karen S. Mark, Ph.D.; Associate Professor Pharmaceutical Sciences 1|Page
 Integrated Medicinal Chemistry and Pharmacology II - Winter Quarter
Reading Assignment and General Outline

Foye’s (7th ed.) Chapter 31 – Non-Steroidal Anti-inflammatory Drugs

 Figures – DMARDS: 31.31, 31.32, 31.34, 31.4, 31.35, 31.36
 Pages: 1023 – 633: Disease Modifying Anti-rheumatic Drugs (DMARDs)
o Page: 1023 – 1024: background
o Pages: 1026 - 1029: aminoquinolines and other synthetic small molecules;
methotrexate, hydroxychloroquine, tofacitinib, etc.
o Pages: 1029 - 1034: Biologic DMARDs; adalimumab, abatacept, tocilizumab,
anakinra, etc.

Goodman & Gilman (13th ed.) Ch 38: Pharmacotherapy of Inflammation, Fever, Pain and Gout
Mostly focus on the large print sections except for bulleted items
 Table 38-5: Classifies DMARDs as Small molecule or Biologicals; and references
alternate chapters (#34, 35, 37, 38, 51, 53, 59, 66, 67, 71) for more information
 Pages 701-702: Brief summary of DMARDs and use of anti-inflammatories

PSC6311 – iMCP-2 Karen S. Mark, Ph.D.; Associate Professor Pharmaceutical Sciences 1|Page