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Nonbiologic disease modifying antirheumatic drugs, or DMARDs for short, are a group of medications primarily used to treat rheumatoid arthritis. The most commonly used ones are methotrexate, azathioprine, sulfasalazine, and hydroxychloroquine. Now, in addition to rheumatoid arthritis, each of these medications has its own set of indications. So, methotrexate can be used to treat psoriasis, inflammatory bowel disease or IBD, and certain cancers. Azathioprine can be also given to clients who have received a renal transplant to prevent rejection. Sulfasalazine is also indicated for IBD and HIV infection. Finally, hydroxychloroquine can be also used to treat malaria, systemic lupus erythematosus, and even some forms of arthritis, such as rheumatoid arthritis and juvenile idiopathic arthritis.
Now, nonbiologic DMARDs can be administered orally, subcutaneously, intramuscularly, and intravenously. Once administered, they mainly work by inhibiting the immune response and blocking the proliferation of endothelial cells and fibroblasts at the involved joints, slowing the progression of rheumatoid arthritis.
However, nonbiologic DMARDs can cause some notable side effects, such as bone marrow depression, which can lead to leukopenia and increased risk for infections. Other general side effects include gastrointestinal disturbances, such as anorexia, nausea, vomiting, and diarrhea.
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