Hydroxychloroquine Flashcards
What is the name of the class hydroxychloroquine belongs to?
antimalarials
antirheumatoid agents
What are other drugs that belong in this class?
chloroquine
mepacrine
plaquenil
What is hydroxychloroquine used for?
disease modifying anti-rheumatic drug, antimalarial.
active rheumatoid arthritis (+juvienile idiopathic arthritis), systemic and discoid lupus, and other dermatological conditions caused or aggravated by sunlight.
What is the mechanism of action of hydroxychloroquinine?
Inhibits function of toll-like receptors that contribute to
autoimmune disease, limiting B cell and dendritic cell
activation.
May inhibit interleukin-1 release by monocytes decreasing macrophage chemotaxis and phagocytosis.
What is the dose of hydroxychloroquinine given?
200-400mg/day
Max 6.5mg/kg/day
What are the contraindications of hydroxychloroquine?
pre exisiting retinopathy
hypersensitivity to 4-aminoquinolines
prolonged use in children
What are the adverse effects of hydroxychloroquine use?
macular damage - main side effect.
headache, nausea, rash, photosensitivity, skin pigmentation. neuromyopathy (rare)
What are the alarm bells with hydroxychloroquine use?
patient should have opthalmological review annually with formal opthalmology review at 5 years.
What are the major pharmacokinetic/pharmacodynamic parameters of hydroxychloroquine?
Absorption: rapid and completely absorbed following oral administration
~45% protein bound
Metabolism partially hepatic
Elimination Halflife ~50 days (blood) and 32 days (plasma)
What are the common interactions with hydroxychloroquinine?
Increases effect and toxicity of methotrexate - monitor closely
Increases effect of digoxin
increased risk of arrhythmias when given with amiodarone/bosutinib/droperidol/moxifloxacin.
increases plasma concentration of ciclosporin
increased risk of convulsions when given with mefloquine
