Rheumatoid Arthritis meds

Question 1

What is the use of Hydroxychloroquine? DMARD

Answer 1

It is an antimalarial

Relieves Severe inflammation

Question 2

What are the adverse effects and contraindications of Hydroxychloroquine? DMARD

Answer 2

Contraindications: hepatic or renal disease, alcoholism
Adverse effects: retinopathy, anorexia, upsets stomach, loss of hair, unusual skin pigmentation
Will get maximum benefits of medication in 6 months of therapy

Question 3

What is the use of Methotrexate? DMARD

Answer 3

Immunosuppressor and antimimotic

Prevents the breakdown of cells

Question 4

What are the contraindications/cautions and adverse effects of Methotrexate? DMARD

Answer 4

Shot or pill taken once weekly
Contraindications/ Cautions: Hepatic and renal disease, infections, blood dyscrasias, very young and very old
Adverse Effects: hepatotoxicity, bone marrow suppression, malaise, fetal defects (X), infections, sudden death
Baseline and monitor CBC, LFT, renal function tests
Don’t take multivitamins with folic acid or proton pump inhibitors

Question 5

What is the use of Adalimumab? DMARD

Answer 5

Inhibits tumor necrosis factor thereby blocking the normal inflammatory and immune response.
Takes 12 weeks to see effects

Question 6

What are the contraindications and Adverse effects?

Answer 6

Given SQ every week, can enhance or inhibit immune resonse=so not fighting itself
Contraindications/ cautions= active infection, neoplastic disease, CV disease, Neuro Disease, active or latent TB
Adverse infections= infections, fatigue, HTN, injection site irritation
DON’T GIVE LIVE VACCINES WITH THIS

Question 7

What is the use of Celecoxib? (Cox-2 Inhibitors)

Answer 7

Inhibits prostaglandin synthesis by inhibiting Cox-2

Monitor CBC Fluid Retention

Question 8

What are the contraindications and adverse effects of Celecoxib?

Answer 8

Contraindications/ Cautions: advanced renal disease, hepatic failure, anemia, GI bleed
Adverse Effects: CV events, dizziness, sinusitis, edema, nausea, flatulence, diarrhea, rash, black tarry stools
Review and monitor NSAIDs

Question 9

What is the use of Prednisone? Systemic Corticosteroid

Answer 9

Suppress histamine and prostaglandins; immunosuppressant and anti-inflammatory
Increases blood sugar
decreases inflammation

Question 10

What are contraindications and adverse effects of Prednisone?

Answer 10

Give with food
Contraindications/ Cautions: Systemic Infections, cataracts, peptic ulcer disease, osteoporosis, HTN, Renal Disease
Serious Adverse effects: suppression of adrenal gland function. Long-term therapy results in cushing syndrome, mood changes, cataracts, peptic ulcers, hypokalemia, osteoporsis
Can mask infections=infections can run rampant with suppressed immune system