DMARDs

Musculoskeletal

Mark this drug class

Examples

methotrexatehydroxychloroquinesulfasalazineleflunomide

Prefix / Suffix: No consistent suffix

Physiology

Autoimmune joint disease causes chronic inflammation that damages cartilage, bone, and function. DMARDs slow the disease process rather than only treating pain.

Mechanism of Action

They suppress or modulate immune pathways involved in inflammation and joint destruction. Methotrexate interferes with folate-dependent cell processes and inflammatory signaling.

Indications

Rheumatoid arthritis
Psoriatic arthritis
Lupus or other autoimmune conditions depending on drug
Disease control to prevent joint damage

Side Effects / Adverse Effects

Bone marrow suppression
Hepatotoxicity
GI upset and mouth sores
Infection risk
Retinal toxicity with hydroxychloroquine
Teratogenicity with methotrexate/leflunomide

Contraindications

Pregnancy for methotrexate and leflunomide
Severe liver disease
Significant bone marrow suppression
Active serious infection

Nursing Considerations

Monitor CBC, liver enzymes, renal function, and infection symptoms
Teach methotrexate is often weekly, not daily, to prevent fatal overdose
Use folic acid with methotrexate if prescribed
Arrange regular eye exams for hydroxychloroquine
Teach to avoid live vaccines unless approved

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Disclaimer: PharmPal Nurse is for education only and is not medical advice. Do not use it to diagnose, treat, prescribe, or make patient-care decisions; always verify with current drug references, your instructor, facility policy, and a licensed provider. In emergencies, call local emergency services.