Peripheral Ulcerative Keratitis Medication

Updated: Jun 11, 2019
  • Author: Ellen N Yu-Keh, MD; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Medication

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and to prevent complications.

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Systemic corticosteroids

Class Summary

Have both anti-inflammatory (glucocorticoid) and salt-retaining (mineralocorticoid) properties. Glucocorticoids have profound and varied metabolic effects. In addition, these agents modify the body's immune response to diverse stimuli.

Prednisone (Deltasone, Orasone, Meticorten)

A synthetic glucocorticoid steroid with nonspecific anti-inflammatory and immunosuppressive effects.

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Immunosuppressant agents

Class Summary

Inhibit key factors that mediate immune response.

Tacrolimus ointment (Protopic)

Macrolide antibiotic that shares many pharmacologic properties with cyclosporine, and is similar in effects but does not produce cytotoxicity. Tacrolimus suppresses cell-mediated immunity by inhibiting DNA translation of specific lymphokines and the expression of the interleukin-2 receptor on activated T cells.

Methotrexate (Folex PFS, Rheumatrex)

A folic acid analog. Acts on the enzyme dihydrofolate reductase, which catalyses the reduction of folate to tetrahydrofolate, a compound necessary for DNA synthesis. Actively replicating cells, such as the leukocyte, are affected and their functions suppressed.

Azathioprine (Imuran)

A purine nucleoside analog that is activated in the liver producing metabolites, which interfere with purine metabolism. T- and B-cell functions are suppressed.

Cyclosporin A (Sandimmune, Neoral, SangCyA)

An 11-amino acid cyclic peptide and a natural product of fungi. Cyclosporine acts on T-cell replication and activity.

Cyclophosphamide (Cytoxan)

Nitrogen mustard derivative, which affects cell replication by alkylating purines in DNA and RNA.

Chlorambucil (Leukeran)

Slow-acting nitrogen mustard derivative, which interferes with DNA replication, transcription, and nucleic acid function by alkylation.

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Disease modifying agents

Class Summary

These agents alter the immune response to diverse stimuli.

Infliximab (Remicade)

Chimeric IgG1k monoclonal antibody that neutralizes cytokine TNF-α and inhibits its binding to TNF-α receptor. Reduces infiltration of inflammatory cells and TNF-α production in inflamed areas. Used with methotrexate in patients who have had inadequate response to methotrexate monotherapy.

Rituximab (Rituxan)

It is a chimeric monoclonal antibody directed against the CD20 protein, which is found primarily on the surface of B cells.

Adalimumab (Humira)

A human monoclonal antibody against tumour necrosis factor (TNF).

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