Rheumatoid drug reactions Flashcards
cyclosporin and tacrolimus
renal dysfunction, hypertension, diabetes, tremor
azathioprine and mylophenoate
leucopenia, anaemia, GI side effects
Steroids
osteoporosis, weight gain, infection, diabetes
NSAIDs
ibuprofen, naproxen, diclofenec, indomethacin
Dyspepsia, oesophagitis, gastritis, peptic ulcer, small/large bowel ulceration, renal impairment, increased cardiovascular events, fluid retention, wheeze, rash
Methotrexate
leucopenia/thrombocytopenia, hepatic cirrhosis, pneumonitits, rash/mouth ulcers, n/d, needs monitoring FBC and LFTS
teratogenic - stop 3 months before contraception
sulfalazine
nausea, rash/mouth ulcers, neutropenia, hepatitis, reversible oligozoospernia, heinz body anaemia, monitoring of FBC and LFTs
hydroxychloroquine
retinopathy - rare
corneal deposits
Anti TNF
major risk of infection - latent TB
possible risk of malignancy - skin cancer
contraindicated in situations like pulmonary fibrosis, heart failure
allopurinol
rash (vasculitis) common in elderly and in renal impairment therefore given in lower doses
azathioprine interaction, marrow aplasia - rare
febuxostat
those who cannot tolerate allopurinol
renal impairment
use with caution in patients with ischaemic heart disease
Corticosteroids
weight gain, muscle wasting, skin atrophy, osteoporosis, diabetes, hypertension, cataracts, glaucoma, fluid retention, adrenal suppression, immunosuppression, avascular necrosis of femoral head
leflunomide (DMARD)
liver impairment, interstitial lung disease, hypertension
prednisolone
cushioned features, osteoporosis, impaired glucose tolerance, hypertension, cataracts
gold
proteinuria
penicillamine
proteinuria, exacerbation of myasthenia graves
