Rheumatoid Drugs Flashcards Preview

RB Y2 MSK 02 - Rheumatology > Rheumatoid Drugs > Flashcards

Flashcards in Rheumatoid Drugs Deck (25)
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1
Q

Methotrexate mechanism

A
  • folate antagonist - binds to dihydrofolate reductase
  • give orally or subcutaenous
2
Q

adverse effects of Methotrexate

A
  • pneumonitis - pulmonary fibrosis
  • hepatotoxocity
  • myelosuppression
  • rash/mouth ulcers
  • leucopenia
  • thrombocytopenia
  • GI upset - nausea and diarrhoea
3
Q

what should be avoided with Methotrexate

A
  • Avoid giving trimethoprim and co-trimoxazole as they are anti-folate antibiotics
  • Additive folate depletion causes bone marrow aplasia
4
Q

is Methotrexate safe in pregnancy

A

no, teratogenic, stop males and females 3 months before conception

5
Q

what type of drug is Sulfasalazine

A

aminosalicylate

6
Q

mechanism of action of Sulfasalazine

A

unknown

7
Q

how is Sulfasalazine adminstered

A

orally

8
Q

adverse effects of Sulfasalazine

A
  • •Temporary oligospermia
  • •Severe depression
  • •Thrombocytopenia
  • •Hepatitis
  • •Neutropenia
  • •GI upset
  • •Ulcers/rash

S for skin, sad and sperm

9
Q

what type of drug is Hydroxychloroquine

A

anti malarial

10
Q

adverse effects of Hydroxychloroquine

A

•Irreversible Retinopathy

  • Corneal deposits
  • Haemolytic anaemia
  • GI upset
11
Q

mechanism of action of Leflunomide

A

inhibits dihydroorotate dehydrogenase

12
Q

main adverse effect of Leflunomide

A

interstitial lung disease

13
Q

what is another name for IM gold

A

Sodium aurothiomalate

14
Q

how is gold given

A

IM

15
Q

adverse effects of IM gold

A
  • bone marrow suppression
    • stop drug until platelets etc recover
  • glomerulonephritis
  • rash
  • mouth ulcers
16
Q

what must be monitored during adminstration of IM gold

A
  • FBC
  • plus urine for proteinuria
17
Q

mechanism of action of Penicillamine

A

copper chelating drug, used in Wilson’s disease

18
Q

adverse effects of Penicillamine

A

same as for IM gold

19
Q
A
20
Q

adverse effects of anti-TNF drugs

A
  • reactivate latent TB
  • skin cancer
  • risk of infection
21
Q

what are anti-TNF drugs contra indicated in

A

pulmonary fibrosis and heart failure

22
Q

which is the only biologic which can be used in connective tissue disease

A

rituximab (can’t use anti-TNF) and Belimumab

23
Q

name 6 adverse effects of steroids

A
  • weight gain - centripetal obesity
  • muscle wasting
  • skin atrophy
  • osteoporosis
  • diabetes
  • hypertension
24
Q

name 4 things that must be done for someone on steroid therapy

A
  • lowest dose for shortest time
  • consider steroid sparing agents
  • OP prophylaxis
  • watch CV risk factors
25
Q

allopurinol and azathioprine

A

they are both xanthine oxidase inhibitor and will cause bone marrow suppression - do not give!