RA

Question 1

Dose of MTX

Answer 1

7.5 to 20 mg po or subq once weekly

Question 2

Contraindications to MTX

Answer 2

Severe alcohol use&alcoholic liver disease, pregnancy, severe renal or hepatic impairment, pre existing bone marrow suppression, or blood dyscaraias (anemia, leukopenia)

Question 3

ADRs of corticosteriods

Answer 3

Adrenal suppression, dyslipidemia, hypertension, delayed wound healing, cataracts, decreased bone mineral density, glucose intolerance, psychosis

Question 4

How long does it take MTX to start working?

Answer 4

Several weeks to months

Question 5

What tests should be done at baseline for MTX

Answer 5

CBC, LFTs, Scr, CXR within 1 yr of tpx

Question 6

MTX DDIs

Answer 6

Alcohol (increases LFTs), probenecid and penicillin (decreases renal tubular secretion), NSAIDs and salicylates (decreases MTX secretion), Bactrim (rare: bone marrow suppression)

Question 7

ADRs of MTX

Answer 7

N/V (divide dose), increases LFTs, mouth ulcers (oral hygiene), alopecia, rare: pneumonitis, URI, epitaxis, fever, infection

Question 8

Which cDMARDs can be used in pregnancy?

Answer 8

Hydroxycholoroquine (in mild to low disease)
Sulfasalazine (in moderate disease)