Treatment of RA: adverse reaction Flashcards
Corticosteroids (CS)
Cataracts, glaucoma, thinned skin, striae, diabetes, hirsutism, acne, hypertension, weight gain, HPA axis suppression, myopathy, GI, cardiovascular, infectious, neurologic complications, osteonecrosis
Methotrexate (MTX)
- Hepatotoxicity
- Pulmonary toxicity
- Fetal abnormalities
- Gastrointestinal, stomatitis, hematologic, rash, alopecia, CNS effects, Nephrotoxicity, rash, oligospermia, gynecomastia, localized osteoporosis
Sulfasalazine (SAS, SSZ)
- GI effects common,
- rash, photosensitivity, Dizziness, headache, reversible oligospermia, megaloblastic, hemolytic, aplastic anemias
Leflunomide (Arava)
- Increased liver enzymes
- Teratogenicity
- GI (diarrhea, nausea, abdominal pain), hypertension, reversible alopecia, rash, headache, paresthesias, Stevens-Johnson syndrome, toxic epidermal necrolysis, bone marrow suppression
Hydroxychloroquine
- Retinal damage
- GI side effects, rash, insomnia, myopathy, rarely leukopenia
Minocycline
Hyperpigmentation, photosensitivity, dizziness, vaginal yeast infection; may decrease efficacy of oral contraceptives
Cyclosporine (CY)
- Nephrotoxicity
- hypertension
- gingival hyperplasia
- hyperkalemia
- hyperuricemia
- hypomagnesemia, gastrointestinal problems, neuropathies, hirsutism
Azathioprine
- leukopenia (dose related)
- Gastrointestinal upset, thrombocytopenia
Gold
Toxicity, diarrhea
D-penicillamine
Toxicity
Cyclophosphamide
Toxicity, risk of malignancy
Tofacitinib
- Increased LDL cholesterol
- increased LFTs
- GI perforation
- Herpes zoster
- neutropenia/bone marrow suppression, headache, diarrhea, Tb
Baricitinib
- Increased LDL cholesterol
- increased LFTs
- GI perforation
- Herpes zoster
- neutropenia/bone marrow suppression, headache, diarrhea, Tb
- black box warning about thrombosis (DVT, PE, arterial)
Etanercept
Injection site reactions (rash); upper respiratory tract symptoms
Infliximab
Acute infusion reactions, hypersensitivity, increased infection risk, + ANA, lupus (rare), leukopenia, neutropenia, thrombocytopenia, pancytopenia