Rheumatoid Medications

Question 1

Methotrexate: indications (4)

Answer 1

Inflammatory arthritis
Psoriasis
Some chemotherapy
Crohns

Question 2

Methotrexate: adverse effects (5)

Answer 2

Mucositis
Myelosuppression
Pneumonitis
Pulmonary fibrosis
Liver cirrhosis

Question 3

Methotrexate: family planning (women)

Answer 3

Avoid pregnancy for at least 3 months after treatment has stopped

Question 4

Methotrexate: family planning (men)

Answer 4

Use affective contraception for at least 3 months after stopping Tx

Question 5

Methotrexate: dose

Answer 5

Initial: 7.5mg once weekly
Step up 2.5mg weekly
Max 25mg per week

Question 6

Methotrexate: what monitoring tests do you do?

Answer 6

FBC, LFTs, U&Es

Question 7

Methotrexate: how often do you do monitoring tests

Answer 7

Before starting treatment
Every 2 weeks until therapy stabalised
Then every 2-3 months

Question 8

Methotrexate: 4 counselling points

Answer 8

Avoid pregnancy
Blood tests regularly
Report signs of infection
Take folic acid

Question 9

Methotrexate: interactions (antibiotics)

Answer 9

Trimethoprim or cotrimoxazole

Question 10

Methotrexate: co-prescription

Answer 10

Folic acid 5mg once weekly

more than 24 hours after methotrexate dose

Question 11

TNF-alpha inhibitors: adverse effect

Answer 11

Reactivation of TB