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FINALS > rheumatology drugs > Flashcards

rheumatology drugs Flashcards

1
Q

when is methotrexate indicated in rheumatology?

A

humanoid arthritis
ankylosing spondylitis with peripheral disease
psoriatic arthritis

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2
Q

what are the side effects of methotrexate?

A 
teratogenic 
hepatotoxicity (liver cirrhosis) 
myelosupression/agranulocitosis 
pulmonary fibrosis/pnuemonitis 
mucositis (sore inflamed gums) 
raises and mouth ulcers
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3
Q

what monitoring is required for methotrexate? when and how often?

A

FBC and LFTs regularly
checked prior to starting
then repeated weekly until stable
then monitored every 2-3 months

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4
Q

what is the relevance of pregnancy and methotrexate?

A

teratogenic
need to have stopped methotrexate 6 months prior to conceiving
men need to use contraception for 6 months too before conceiving

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5
Q

how is methotrexate taken?

A

weekly

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6
Q

what should be co-prescribed with methotrexate? how should it be taken?

A

folic acid

taken more than 24 hours after methotrexate

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7
Q

what antibiotics should be avoided co-prescribing with methotrexate? and why?

A

trimethoprim
co-trimoxazole
can increase risk of marrow aplasia

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8
Q

what other drug should be avoided with methotrexate and why?

A

aspirin

increases risk of toxicity secondary to reduced excretion

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9
Q

how does leflunomide work?

A

similar to methotrexate

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10
Q

what do you need to be careful of with leflunimoide?

A

long half life so requires wash out

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11
Q

what are the side effects of sulfasalazine?

A

hepatotoxicity
rash
reversible oligozoospermia

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12
Q

what is the indication to use azathioprine?

A

connective tissue disease

vasculitis

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13
Q

what is the side effects of azathioprine?

A

hepatotoxicity

agranulocytosis

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14
Q

what drug when co-prescribed with azathioprine causes agranulocytosis?

A

allopurinol

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15
Q

what can gold be used to treat?

A

rheumatoid arthritis

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16
Q

what are the side effects of gold?

A

glomerulonephritis

proteinuria

17
Q

what needs to be monitored with gold?

A

U&Es

18
Q

how is gold administered?

A

IM

19
Q

what is hydroxychloroquine used for?

A

connective tissue disease (SLE)

20
Q

what is a side effect of hydroxychloroquine?

A

irreversible retinopathy

21
Q

can hydroxychloroquine be used in pregnant people?

A

yes

22
Q

what are the names of anti-TNF drugs?

A

etanercept
infliximab
golimumab
adalimunab

23
Q

what are anti-TNF drugs used to treat?

A

rheumatoid arthritis
psoriatic arthritis
ankolsying spondylitis

24
Q

what are the side effects of anti-TNF drugs?

A

reactivation of TB
increased susceptibility of infection
increased risk of skin cancer

25
Q

what are anti-TNF drugs used in combination with?

A

methotrexate

26
Q

in what conditions are anti-TNF drugs contraindicated?

A

TB
pulmonary fibrosis
heart failure

27
Q

what it the name of an anti-CD20 antibody?

A

rituximab

28
Q

what can rituximab cause?

A

myelotoxicity

pulmonary toxicity

29
Q

what is colchicine used for?a

A

acute gout

30
Q

what are the side effects of colchicine?

A

N & D

31
Q

when is colchicine used in acute gout?

A

2nd line

when patients can’t take NSAIDs

32
Q

what is allopurinol used for?

A

gout prophylaxis

33
Q

what are the side effects of allopurinol?

A

vasculitic rash

inhibition of warfarin metabolism

34
Q

why should you be careful when prescribing for gout?

A

can precipitate an acute attack

needs to be covered with NSAIDs or colchicine

35
Q

how does allopurinol work?

A

works as an xanthine oxidase inhibitor

36
Q

when are steroids used in rheumatology?

A

rheumatoid flare ups
immunosuppression while DMARDs get to work
acute gout

37
Q

what are the side effects of steroids?

A

weight gain
muscle wasting
osteoporosis
hypertension

FINALS (25 decks)

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