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Rheumatology > Drugs > Flashcards

Drugs Flashcards

1
Q

Give some examples of NSAIDs

A 
Ibuprofen
Naproxen
Diclofenac
Indometacin
Etodolac
Celecoxib (COX 2 inhibitor)
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2
Q

List some of the adverse effects of NSAIDs?

A 
Dyspepsia
Oesophagitis
Gastritis
Peptic ulcer
Small/large bowel ulceration
Renal impairment
Increased CV events
Fluid retention
Wheeze
Rash
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3
Q

Name 4 commonly used DMARDs

A

Methotrexate
Sulphasalazine
Leflunomide
Hydroxychloroquine

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4
Q

Which DMARD is usually first choice? How can it be given?

A

Methotrexate PO or SC

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5
Q

What are the adverse effects of methotrexate?

A 
Leucopenia/thrombocytopenia
Hepatitis/cirrhosis (limit alcohol)
Pneumonitis
Rash + mouth ulcers
Nausea + diarrhoea
Teratogenic
Agranulocytosis
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6
Q

What needs to be monitored in patients taking methotrexate?

A

FBC –> leucopenia/thrombocytopenia

LFTs –> cirrhosis

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7
Q

What is the rule regarding pregnancy and methotrexate?

A

Must be stopped at least 3 months before conception

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8
Q

What are the adverse effects of leflunomide?

A

Similar to methotrexate
Also teratogenic
Very long half life so requires wash out

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9
Q

What are the adverse effects of sulphasalazine?

A 
Nausea
Rash + mouth ulcers
Neutropenia
Hepatitis
Reversible oligozoospermia
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10
Q

What needs to be monitored in a patient taking sulphasalazine?

A

FBC

LFTs

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11
Q

What is a notable but rare adverse effect of hydroxychloroquine?

A

Retinopathy

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12
Q

Gold and penicillamine are also used as DMARDs, what are their adverse effects?

A

Bone marrow suppression
Glomerulonephritis
Rash + mouth ulcers

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13
Q

What needs to be monitored in patients taking gold or penicillamine?

A

FBC

Urine for proteinuria

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14
Q

What are the adverse effects of biologics?

A

Risk of infection –> especially TB

May be increased risk of cancer, especially skin cancer

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15
Q

When are biologics contraindicated?

A

Pulmonary fibrosis

Heart failure

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16
Q

What is a common sider effect of colchicine?

A

Diarrhoea

17
Q

What are some of the adverse effects of allopurinol?

A 
Rash (vasculitis) - commoner in elderly and in renal impairment so use lower dose
Azathioprine interaction
Marrow aplasia (rare)
18
Q

When is febuxostat used?

A

For gout prophylaxis in those who cannot tolerate allopurinol

19
Q

What is an adverse effect of febuxostat and in which condition should it be used cautiously?

A

May cause renal impairment

Use with caution in patient with IHD

20
Q

List some adverse effects of corticosteroids

A 
Weight gain - centripetal obesity
Muscle wasting
Skin atrophy
Osteoporosis
Diabetes
Hypertension
Cataract
Glaucoma
Fluid retention
Adrenal suppression
Immunosuppression
Avascular necrosis of femoral head
21
Q

What factors should be considered when prescribing steroids?

A
  • lowest possible dose for shortest possible time
  • consider steroid sparing agents
  • osteoporosis prophylaxis
  • watch CV risk factors

Rheumatology (8 decks)

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