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Rheumatoid Arthritis
| Question | Answer |
|---|---|
| Clinical presentation | affects PIP joints, MCP joints, metatarsal joints, wrists, ankles, elbows, shoulders, sternoclavicular joints, temporomandibular joints, hips, knees, morning stiffness, ulnar deviation, boutinere, felty's, sjrogens |
| Diagnosis | morning stiffness or nrea joints lasting one hours before imporvement; 3 or more joints; RF+, CRP, ESR - 6 weeks |
| DMARDS | Hydroxychloroquine, sulfasalazine, MTX, gold, auranofin, azathioprine, penicillamine, minocycline, leflunomide, etanercept, infliximab, anakinra, adalimumab |
| Diclofenac | Voltaren |
| Etodolac | Lodine |
| Indomethacine | Indocin |
| Nabumetone | Relafen |
| Tolmetin | Tolectin |
| Sulindac | Clinoril |
| Fenoprofen | Nalfon |
| Flurbiprofen | Ansaid |
| Ibuprofin | Motrin |
| Ketoprofen | Orudis |
| Ketoprofen SR | Oruvail |
| Naproxen | Naprosyn |
| Oxaprozin | Daypro |
| Meclofenamate | Meclomen |
| Piroxicam | Feldene |
| Celecoxib | Celebrex |
| Hydroxychloroquine | Plaquenil |
| Sulfasalazine | Azulfidine |
| Methotrexate | Rheumatrex |
| Gold soidum thiomalate | Myochrisine |
| Auranofin | Ridaura |
| Azathioprine | Imuran |
| Penicillamine | Cuprimime |
| Minocycline | Minocin |
| Leflunomide | Arava |
| Etanercept | Enbrel |
| Infliximab | Remicade |
| Anakinra | Kineret |
| Adalimumab | Humira |
| FDA approved drug for NSAID induced ulcers | Lansoprazole |
| Arthrotec | Misoprostol + Diclofenac |
| the NSAIDs that carry lower risk of ulceration and GI symptoms | Ibuprofen, Nabumetone, Naproxen |
| Plaquenil ADRs | retinal damage esp if dose more than 800 or >75 years, rash, ab cramp, diarrhea, myopathy, skin pigment changes, peripheral neuropathy |
| Azulfidine ADR | HA, GI intolerance, dysguesia, rash, leukopenia, thrombocytopenia |
| Azulfidine DDI | folic acid |
| Rheumatrex ADR | liver damage, leukopenia, thrombocytopenia, pancytopenia, N/V, stomatitis |
| Rheumatrex DDI | ASA, NSAIDs, Bactrim; take with folic acid |
| Arava ADR | diarrhea, increase LFTs, alopecia, HTN, rash |
| Arava DDI | liver tox when used with MTx; bactrim |
| if patient decides to become pregnant on Arava, use this drug elimination drug procedure | 8 g cholestyramine TID x 11 days; need to verify with two M1<0.02 14 days a part |
| Cuprimine ADR | thrombocytopenia, leukopenia, proteinuria, skin rash, stomatitis, dysguesia, polymyositis |
| Cuprimine DDI | antacids, digoxin, gold |
| Gold ADR | weakness, flushing, dizziness, sweating, syncope, hypotension, RASH, proteinuria, microscopic hematuria, leukopenia, thrmbocytopenia |
| Gold DDI | increase risk of rash with hydroxychloroquine |
| TNF alpha inhibitors ADRs | mycobacterial, fungal, opportunistic infectious complications (sepsis, TB), rash, HA, nausea, cough, lymphoma; infliximab causes cardiac side effects; test for TB before starting TNFalphas |
| Kineret ADRs | increase risk of infections, injection site reactions, HA, nausea, diarrhea, sinusitis, flu-like symptoms, ab pain |
Created by:
cytoskeletor
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