Chapter 10 BNF (MSK) Flashcards
How is newly diagnosed Rheumatoid Arthritis treated?
Methotrexate + DMARD + Temporary steroid
Which DMARDs cause blood dyscrasias?
Sulfasalazine Penicilliamine Gold Infliximab Eternacept Methotrexate
Which DMARDs cause nephrotoxicity?
Ciclosporin
Leflunamide
Which DMARD causes urothelial toxicity and haemorrhaging cystitis and permanent male sterility ?
Cyclophosphamide
How long must contraception be used after leflunomide?
2 years women
3 months men
What should a patient do if they miss a methotrexate dose?
If 3 or more days, take on next scheduled day
Side effects of methotrexate?
Blood dyscrasias Hepatotoxicity Nephrotoxicity Pulmonary GI
How long must contraception be taking after taking methotrexate?
6 months
What are the interactions with methotrexate?
Blood disorders
NSAIDs (reduced renal excretion)
Hepatotoxicity
Which drugs cause hyperuricaemia?
Diuretics
Ciclosporin/ Tacrolimus
Cytotoxics
Cancer
When is colchicine indicated for acute gout?
Can’t take NSAID due to HF
Counselling points for colchicine?
Do not repeat course in 3 days
Max 6mg per course
Which drugs are available for prevention of gout?
Allopurinol
Feboxustat (hypersensitivity)
Sulfjnapyrazone (ensure good renal function )
When should gout prophylaxis be started
1/2 weeks after attack
when is quinine sulphate appropriate for nocturnal leg cramps?
Sleep disturbed
Painful
Treatable cause excluded
