rheumatology drugs Flashcards
when is methotrexate indicated in rheumatology?
humanoid arthritis
ankylosing spondylitis with peripheral disease
psoriatic arthritis
what are the side effects of methotrexate?
teratogenic hepatotoxicity (liver cirrhosis) myelosupression/agranulocitosis pulmonary fibrosis/pnuemonitis mucositis (sore inflamed gums) raises and mouth ulcers
what monitoring is required for methotrexate? when and how often?
FBC and LFTs regularly
checked prior to starting
then repeated weekly until stable
then monitored every 2-3 months
what is the relevance of pregnancy and methotrexate?
teratogenic
need to have stopped methotrexate 6 months prior to conceiving
men need to use contraception for 6 months too before conceiving
how is methotrexate taken?
weekly
what should be co-prescribed with methotrexate? how should it be taken?
folic acid
taken more than 24 hours after methotrexate
what antibiotics should be avoided co-prescribing with methotrexate? and why?
trimethoprim
co-trimoxazole
can increase risk of marrow aplasia
what other drug should be avoided with methotrexate and why?
aspirin
increases risk of toxicity secondary to reduced excretion
how does leflunomide work?
similar to methotrexate
what do you need to be careful of with leflunimoide?
long half life so requires wash out
what are the side effects of sulfasalazine?
hepatotoxicity
rash
reversible oligozoospermia
what is the indication to use azathioprine?
connective tissue disease
vasculitis
what is the side effects of azathioprine?
hepatotoxicity
agranulocytosis
what drug when co-prescribed with azathioprine causes agranulocytosis?
allopurinol
what can gold be used to treat?
rheumatoid arthritis
what are the side effects of gold?
glomerulonephritis
proteinuria
what needs to be monitored with gold?
U&Es
how is gold administered?
IM
what is hydroxychloroquine used for?
connective tissue disease (SLE)
what is a side effect of hydroxychloroquine?
irreversible retinopathy
can hydroxychloroquine be used in pregnant people?
yes
what are the names of anti-TNF drugs?
etanercept
infliximab
golimumab
adalimunab
what are anti-TNF drugs used to treat?
rheumatoid arthritis
psoriatic arthritis
ankolsying spondylitis
what are the side effects of anti-TNF drugs?
reactivation of TB
increased susceptibility of infection
increased risk of skin cancer
