Rheumatology Drugs Flashcards
Methotrexate mechanism?
Folate antagonist
Methotrexate side effects?
Myelosuppression
Liver cirrhosis
Pneumonitis (urgent respiratory help)
Teratogenic (stop 3 months before conception - both male and female)
Sulfasalazine side effects?
Oligospermia (decreased sperm count)
Rash
Mouth ulcers
Heinz body anaemia
Hydroxychloroquine drug class?
Anti-malarial
Hydroxychloroquine side effects?
Irreversible retinopathy (annual ophthalmology review) Corneal deposits
Leflunomide mechanism?
Inhibits Dihydroorotate dehydrogenase
Leflunomide side effects?
Interstitial lung disease
Hepatotoxicity (liver impairment)
Hypertension
Oral ulcers
TERATOGENIC - not given in pregnancy, to female or male partner
IM Gold side effects?
Proteinuria
Peripheral neuropathy
Mechanism of penicillamine?
Unknown in RA
Chealating agent in Wilson’s Disease
Side effects of penicillamine?
Rash - pseudoxanthoma elasticum
Aggravation of myasthenia syndrome
Proteinuria
Azathioprine class?
Mercaptopurine derivative
Azathioprine side effects?
Marrow suppression (myelosuppression)
Hepatotoxicity
Acute pancreatitis
Teratogenic
Mechanism of ciclosporin?
Blocks cytotoxic T cell activation (CD8+)
Ciclosporin side effects?
Immune suppression - therefore infection risk
Nephrotoxicity
Hypertension
Hepatotoxicity
Prednisolone mechanism?
Binds glucocorticoid receptor (alpha/beta)
Prednisolone effects?
Salt/water retention
Increased gluconeogenesis
Increased hepatic glycogen deposition
Increased protein breakdown
Prednisolone side effects?
Osteoporosis Impaired glucose tolerance (potentially DM) Hypertension Cataracts Glaucoma Cushingoid features (central obesity) Adrenal suppression AVN of femoral head Immunosuppression
Subcutaneous anti-TNF drugs?
Etanercept
Adalimumab
Certdizumab
Golimumab
IV anti-TNF drugs?
Infliximab
Anti-TNF therapy side effects?
All - reactivation of TB
Increased skin cancer potentially?
Etanercept - demyelination
Contraindications for anti-TNF therapy?
Heart failure
Pulmonary fibrosis
Latent TB
What causes oligospermia?
Sulfasalazine
What causes proteinuria?
Gold
Penicillamine
What causes reactivation of TB?
All anti-TNF
In particular: Infliximab and Etanercept
What causes pulmonary fibrosis?
Methotrexate
Leflunomide
What causes retinopathy?
Hydroxychloroquine
What causes cataracts?
Prednisolone
What causes exacerbation of Myasthenia Gravis?
Penicillamine
What causes demyelination?
Etanercept
What drugs are teratogenic?
Methotrexate
Leflunomide
Azathioprine
What anti-TNF drug is given IV?
Infliximab
2 eye problems caused by prednisone?
Cataracts
Glaucoma
2 eye problems caused by Hydroxychloroquine?
Retinopathy
Corneal deposits
Side effects of Rituximab?
Infusion reactions common
