Rheumatology Flashcards
methotrexate may accelerate or enhance what development?
The formation of rheumatoid nodules.
“gold drugs” may cause what renal disease?
glomerular disease
Of DMARDs for RA, which 2 are considered “safer”?
Hydroxychloroquine, sulfasalazine
Two toxicities of hydroxychloroquine
retinopathy, hyperpigmentation
Two toxicities of sulfasalazine
myelosuppression, GI disturbance
7 SE of MTX
Stomatitis Myelosuppression Hepatic fibrosis Cirrhosis Pulm involvement Worsens rheum nodules teratogenicity
5 Se of leflunomide (for RA)
Hepatotoxicity, nausea, diarrhea, HTN, teratogenicity
5 SE of cyclosporine (for RA)
Renal dysfunction tremor hirsutism HTN gum displasia
4 issues with Gold medications (IM and oral for RA)
Myelosuppression
Renal –> proteinuria (glomerular disease)
Diarrhea (#1 for oral)
Rash (#1 for IM)
3 SE of azathioprine (for RA)
Myelosuppression, hepatotoxiity, lymphoproliferative disorders
Name 7 Non-biologic DMARDs for RA
Hydroxychloroquine Sulfasalazine MTX Leflunomide Cyclosporine Gold (IM or oral) Azathioprine
Name 6 biologic DMARDs for RA
- Anti tumor necrosis factor agents (TNF) - etanercept (enbrel), infliximab (remicade), adalimumab (humira)
- Co-stimulation modulators - abatacept (Orencia)
- Anti-B cell antibodies (rituximab)
- Interleukin (IL)-1 receptor antagonist (anakinra (kineret)
- IL-6 antagonist Tocilizumab (actemra)
- Protein Kinase inhibitors - tofacitinib (xeljanz)
Side effect of rituximab
Anti - b cell antibodies which depletes b cells and might cause progressive multifocal leukoencephalopathy
Side effect of Anti TNF agents (enbrel, remicade, humira)
possible exacerbation of CHF, skin cancer, demyelinating disease, infection
Which two drugs potentiate gout?
thiazides, ASA
