Chapter 10 BNF (MSK) Flashcards

1
Q

How is newly diagnosed Rheumatoid Arthritis treated?

A

Methotrexate + DMARD + Temporary steroid

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2
Q

Which DMARDs cause blood dyscrasias?

A
Sulfasalazine 
Penicilliamine 
Gold 
Infliximab 
Eternacept 
Methotrexate
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3
Q

Which DMARDs cause nephrotoxicity?

A

Ciclosporin

Leflunamide

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4
Q

Which DMARD causes urothelial toxicity and haemorrhaging cystitis and permanent male sterility ?

A

Cyclophosphamide

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5
Q

How long must contraception be used after leflunomide?

A

2 years women

3 months men

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6
Q

What should a patient do if they miss a methotrexate dose?

A

If 3 or more days, take on next scheduled day

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7
Q

Side effects of methotrexate?

A
Blood dyscrasias 
Hepatotoxicity 
Nephrotoxicity 
Pulmonary 
GI
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8
Q

How long must contraception be taking after taking methotrexate?

A

6 months

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9
Q

What are the interactions with methotrexate?

A

Blood disorders
NSAIDs (reduced renal excretion)
Hepatotoxicity

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10
Q

Which drugs cause hyperuricaemia?

A

Diuretics
Ciclosporin/ Tacrolimus
Cytotoxics
Cancer

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11
Q

When is colchicine indicated for acute gout?

A

Can’t take NSAID due to HF

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12
Q

Counselling points for colchicine?

A

Do not repeat course in 3 days

Max 6mg per course

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13
Q

Which drugs are available for prevention of gout?

A

Allopurinol
Feboxustat (hypersensitivity)
Sulfjnapyrazone (ensure good renal function )

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14
Q

When should gout prophylaxis be started

A

1/2 weeks after attack

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15
Q

when is quinine sulphate appropriate for nocturnal leg cramps?

A

Sleep disturbed
Painful
Treatable cause excluded

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16
Q

What are the sides effects of quinine sulphate?

A
QT prolongation (MHRA) 
Convulsions
17
Q

How long does quinine take to work? How often should it be monitored?

A

4 weeks

Every 3 months