Rheumatoid Drugs Flashcards
Methotrexate mechanism
- folate antagonist - binds to dihydrofolate reductase
- give orally or subcutaenous
adverse effects of Methotrexate
- pneumonitis - pulmonary fibrosis
- hepatotoxocity
- myelosuppression
- rash/mouth ulcers
- leucopenia
- thrombocytopenia
- GI upset - nausea and diarrhoea
what should be avoided with Methotrexate
- Avoid giving trimethoprim and co-trimoxazole as they are anti-folate antibiotics
- Additive folate depletion causes bone marrow aplasia
is Methotrexate safe in pregnancy
no, teratogenic, stop males and females 3 months before conception
what type of drug is Sulfasalazine
aminosalicylate
mechanism of action of Sulfasalazine
unknown
how is Sulfasalazine adminstered
orally
adverse effects of Sulfasalazine
- •Temporary oligospermia
- •Severe depression
- •Thrombocytopenia
- •Hepatitis
- •Neutropenia
- •GI upset
- •Ulcers/rash
S for skin, sad and sperm
what type of drug is Hydroxychloroquine
anti malarial
adverse effects of Hydroxychloroquine
•Irreversible Retinopathy
- Corneal deposits
- Haemolytic anaemia
- GI upset
mechanism of action of Leflunomide
inhibits dihydroorotate dehydrogenase
main adverse effect of Leflunomide
interstitial lung disease
what is another name for IM gold
Sodium aurothiomalate
how is gold given
IM
adverse effects of IM gold
- bone marrow suppression
- stop drug until platelets etc recover
- glomerulonephritis
- rash
- mouth ulcers
what must be monitored during adminstration of IM gold
- FBC
- plus urine for proteinuria
mechanism of action of Penicillamine
copper chelating drug, used in Wilson’s disease
adverse effects of Penicillamine
same as for IM gold
adverse effects of anti-TNF drugs
- reactivate latent TB
- skin cancer
- risk of infection
what are anti-TNF drugs contra indicated in
pulmonary fibrosis and heart failure
which is the only biologic which can be used in connective tissue disease
rituximab (can’t use anti-TNF) and Belimumab
name 6 adverse effects of steroids
- weight gain - centripetal obesity
- muscle wasting
- skin atrophy
- osteoporosis
- diabetes
- hypertension
name 4 things that must be done for someone on steroid therapy
- lowest dose for shortest time
- consider steroid sparing agents
- OP prophylaxis
- watch CV risk factors
allopurinol and azathioprine
they are both xanthine oxidase inhibitor and will cause bone marrow suppression - do not give!
