Passmed Rheumatology - Pharmacological Managements Flashcards
Ankylosing spondylitis
NSAIDs
Anti-TNF in rare cases
Anti-phospholipid syndrome
Primary prophylaxis = low-dose aspirin
Secondary prophylaxis = lifelong warfarin INR 2-3, if recurrent VTE INR 3-4
Azathioprine
Bone marrow suppression + pancreatitis
Don’t use with allopurinol
Safe in pregnancy
Gout
Acute = NSAID or colchicine, oral/intra-articular steroid if peptic ulcer disease
Chronic = allopurinol with initial colchicine cover
Hydroxychloroquine
Retinopathy
Safe in pregnancy
Osteoarthritis
1st - Paracetamol +/- topical NSAID (if knee or hand)
2nd - oral NSAIDs/COX-2 inhibitors
Can also consider opioids, IA steroids, capsaicin cream
Osteomalacia
Vit D supplementation +/- calcium supplementation if needed
Osteoporosis
Alendronate
If can’t tolerate = risedronate or etidronate
If can’t tolerate = strontium ranelate, raloxifene
Paget’s disease of the bone
Oral risedronate or IV zoledronate
Polymyalgia rheumatica
Oral prednisolone
Reactive arthritis
Analgesia
NSAIDs
IA steroids
SLE
Hydroxychloroquine
Temporal arteritis
No visual loss = oral high-dose prednisolone
Visual loss = IV methylprednisolone
Sulfasalazine
Myelosuppression, oligospermia
Safe in pregnancy + BFing