MSK MHRA Alerts Flashcards
Tofacitinb can be used for rheumatoid arthriris. A clinical trial of 10mg highlighted what potentially serious CV event associated with this dosage?
Increased risk of pulmonary embolism and mortality in rheumatoid arthritis patients receiving 10mg BD in a clinical trial
Due to these increased risks, prescribers are advised to adhere to the licenced dose for rheumatoid arthritis.
Apremilast may cause which change in behaviour?
Suicidal thoughts/behaviour
Febuxostat may be associated with which reactions? When do the most cases occur?
Serious reports of hypersensitivity reactions, including Stevens-Johnson syndrome and acute anaphylactic shock with febuxostat.
Patients should be advised of the signs and symptoms of severe hypersensitivity; febuxostat must be stopped immediately if these occur (early withdrawal is associated with a better prognosis), and must not be restarted in patients who have ever developed a hypersensitivity reaction to febuxostat.
Most cases occur during the first month of treatment
What factors could indicate potential hypersensensitivity to febuxostat?
A prior history of hypersensitivity to allopurinol and/or renal disease may indicate potential hypersensitivity to febuxostat.
Nusinersen can be used in the treatment of spinal muscular atrophy. Which brain-related complications may occur from this? What are the signs and symptoms?
Hydrocephaly not related to meningitis or bleeding.
Signs: persistent vomiting or headache, unexplained decrease in consciousness, and in children increase in head circumference.
The use of piroxicam has been limited due to its potential to cause to cause which type of side effects?
Increased risk of gastro-intestinal side effects and serious skin reactions.
Which indications is piroxicam limited to?
Use of piroxicam should be limited to the symptomatic relief of osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis
What’s the max dose of piroxicam? When should this treatment be reviewed?
Max dose = 20mg.
Treatment should be reviewed 2 weeks after initiating piroxicam, and periodically thereafter.
Concomitant administration of a gastro-protective agent should be considered.
Which side effect would require treatment cessation if experienced by a patient on tiaprofenic acid?
Cystitis.
It should not be given to patients with urinary-tract disorders and should be stopped if urinary symptoms develop.
Patients should be advised to stop taking tiaprofenic acid and to report to their doctor promptly if they develop urinary-tract symptoms (such as increased frequency, nocturia, urgency, pain on urinating, or blood in urine)
