DMARDs Flashcards
What are methotrexates pregnancy indications
It is a teratogenic and must be taken off 3 months before conception. Use contraception during these 3 months
Side effects of methotrexate (3)
Myelosuppression (bone marrow suppresion), liver cirrhosis and pneumonitis
What should be given along with methotrexate and when
Folic acid should be given 24 hours after dose
When should the DMARD be aimed to start
First 3 months of active disease
How often should patients on methotrexate be checked
Every 4 weeks and escalate medication until pushed into remission
Pregnancy indications of sulfasalazine
It is safe to use during pregnancy but there are reports of fall in sperm count for males
Side effects of sulfasalazine
Rashes, oligospermia, heinz body anaemia.
When should sulfasalzine be avoided
Septrin allergy and G6PD deficiency
Pregnancy indications in leflunomide
Should be avoided during pregnancy and women may need wash-out therapy.
Side effects of leflunomide
Liver impairment, interstitial lung disease and hypertension.
When is hydroxychloloquine used
SLE, sjorgens and RA
Side effects of hydroxychlorquine
Retinopathy and corneal deposits
Pregnancy indications of hydroxychloroquine
Safe
When is azathioprine used
SLE, vasculitis and spondylarthropies
Pregnancy indications of azathioprine
Safe as long as dose is below 2mg/kg
Side effects of azathioprine
Infection, leukopenia, nausea and vomiting
Monitoring for azathioprine
Regular blood tests
Indications of prednisolone for RA
IM steroid 3 injections of 120mg methylprednisolone every 4 weeks
Side effects of prednisolone
Cushinoid features, osteoporosis, impaired glucose tolerance, hypertension and cataracts
Monitoring on prednisolone
Adrenal function
Side effects of gold
Proteinuria
Side effects of penicillamine
Proteinuria and exacerbation of myasthenia gravis
Side effect of etanercept
Demyelination and reactivation of TB
Infliximab pregnancy indications
Stop
