3154 MSK + Haem Flashcards
Warfarin Indications (3)
Mechanical heart valve
Mitral stenosis
Left Ventricular thrombus
Rivaroxaban CI (3)
Contraindicated with phentytoin and phenobarbital, CYP3A4, CrCl < 15
Abixaban CI (2)
Contraindicated with potent CYP3A4 / P-gp inhibitors / inducers, HD
Prednisolone (steroids)
Avoid use for more than 3 months + taper
ADR: osteoperosis, CV risk, glaucoma, GI ulcer
Methotrexate (CI:2, ADR:3)
Contraindicated in CrCl < 30 & pregnancy
ADR: Myelosuppression, increase LFT, SJS/TEN
Sulfasalazine (CI:2)
Avoid in sulfonamide allergy & G6PD
Hydroxychloroquine (CI:2, ADR:1)
CI in retinopathy & G6PD
ADR: retinopathy (eye exam)
Leflunomide (CI:1)
CI in pregnancy, ALT high
TNF-a inhibitors (CI:2, ADR: 6)
CI in heart failure, severe infections
ADR: myelosuppression, CVD, metabolic, GI (vomit, abdominal pain) , thrombosis
bDMARDs & tsDMARD screening (4)
- TB &
- Hep B/C
- Vaccination (influenza, pneumococcal)
- Lab: FBC, LFT, Lipid, SCr
Colchicine (ADR:3)
Nausea
Vomiting
Diarrhoea
Allopurinol ADR
SCAR: HLA-B*5801
Risk factors: renal impairment & old age
Febuxostat
Caution in HF/CHD (MACE risk)
Probenecid (CI:3)
CI: CrCl < 50, urolithiasis, G6PD
Bisphosphonates (CI:5)
CrCl < 30
Hypocalcaemia
Oesophageal / GI problems
Aspiration risk / cannot swallow
Cannot stand/sit upright > 30 min
Bisphosphonates (ADR: 2)
ONJ (smoking cessation, avoid dental, oral hygiene)
atypical femoral fracture (stop)
Denosumab (CI:1)
CI: Hypocalcaemia –> ensure sufficient Ca & Vit D intake
Colchicine (DDI:4)
Azoles
Macrolides
Statin
CCB
Bisphosphonate (admin:4)
Separate 2h from Ca/Fe
Take > 30 min before anything
Remain upright for > 30 min after
Take with 240 mL plain water
Dabigatran (CI:1)
CrCl < 30
