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So let me discuss the other disease-modifying antirheumatic drugs that is a synthetic demand which is nothing but sulfasalazine alright sulfa saladin now let me tell you one important point this particular sulfasalazine this is metabolized to sulfur pirating and as well as fiim i know salicylic acid right this is metabolized to sulfur pi reading and as well as
Fire my no salicylic acid all right now you take this particular sulfur pi reading this sulfur pi reading it is an active moiety right this is an active moiety which is used in the patients with the rheumatoid arthritis alright this is an active moiety which is used in the treatment of rheumatoid arthritis but you take this fire – al slick acid this is used in
The treatment of ulcerative colitis right this is used in the treatment of ulcerative colitis now now when do we use this particular the sulfasalazine remember we use this sulfasalazine in those group of patients where methotrexate is contraindicated so remember this point so wherever the methotrexate is contraindicated there we use this particular sulfasalazine
Next so these are a few points about your sulfasalazine next let me take up the another synthetic demarked which is left you know mind right let me tell you another synthetic diamond that is left luna my remember this particularly life you know mine this is a program right this liliana mine it is a program this left luna might it has to be converted into an
Active metabolite so this is converted to an active metabolite now what does this active metabolite does remember this particular active metabolite it will inhibit the enzyme die hydro orotate dehydrogenase right they will inhibit an enzyme which is called die hydro rotate dehydrogenase right it will inhibit the enzyme dye had ro rotate dehydrogenase now what is
This enzyme useful for remember this particular enzyme dihedral rotate dehydrogenase this is a very important enzyme for pyrimidine synthesis all right this is a very important enzyme in case of the pyrimidine synthesis now what does this pyramid synthesis required for this pyrimidine synthesis this is required for the growth of the b cells for the growth of the
B cells now what did we talk in the introduction what are the group of cells which play an important role in the pathophysiology of rheumatoid arthritis remember it is your b cells which will generate the plasma cells which will generate the auto antibodies that will act against the joint so b cells are the one which play an important path of physiological role
In the development of your rheumatoid arthritis so whenever you are giving left luna my this is a prodrug this has to be converted into an active metabolite and this will inhibit an enzyme which is called as dye i draw or rotate dehydrogenase and what is this enzyme required for this enzyme it is required for pyrimidine synthesis and this pyrimidine synthesis is
Very much important for the growth of the b cells so when you are inhibiting this particular drive hydro rotate dehydrogenase pyrimidine synthesis does not occur and thereby the growth of the b cells will not occur now now whenever you are giving this particularly left you know might there is a very great chance that then individual can develop the left you know
Might toxicity so along with left field amide right along with left you know might if you give cholestyramine right if you give this particular cholestyramine this cholestyramine will decrease the toxicity right this cholestyramine will decrease the toxicity of this left unum id by increasing its clearance right by increasing its clearance so what does this
Cholestyramine do cholestyramine will decrease the toxicity of left you know might by increasing its clearance right this is a very important point you should remember now let me tell you your left you know might you compare all the synthetic demands like what i have discussed for the demands to have their action to be started it takes nearly around six weeks
To six months now among all your the synthetic demands the left you know mind it is the fast-acting right remember this point this is the fast-acting drug in the sense the action of this drug will manifest within four weeks right the action of this particular drug will start within for four weeks and remember this particular lefty on amide it can be used as an
Alternative to methotrexate right this can be used as an alternative to methotrexate so these are some of the points about your left lana my
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Disease-modifying antirheumatic drugs (DMARDs) Part 2 – Pharmacology By Dr.G Bhanu Prakash Animated Medical Videos