Medications

Question 1

Describe the action of azathioprine

Answer 1

A purine analogue that inhibits DNA replication and stops proliferating cells. Must test for TPMT deficiency as can reduce metabolism and cause toxicity. Co-prescribing with allopurinol can cause toxicity.

Question 2

What are the adverse side effects of azathioprine?

Answer 2

Bone marrow suppression causing pancytopenia and immunosuppression

Question 3

Describe the action of methotrexate

Answer 3

Dihydrofolate antagonist that targets proliferating cells. Often given once weekly and folic acid is prescribed on other days. In overdose, folinic acid is used as rescue therapy.

Question 4

What are the adverse side effects of methotrexate?

Answer 4

• Mouth ulcers
• Deranged LFTs
• Pneumonitis
• Bone marrow suppression causing pancytopenia and immunosuppression

Question 5

What are the adverse side effects of hydroxychloroquine?

Answer 5

• Photosensitivity
• Haemolytic anaemia
• Retinal toxicity
• Bone marrow suppression causing pancytopenia and immunosuppression

Question 6

What are the adverse side effects of sulfasalazine?

Answer 6

• Haemolytic anaemia
• Abnormal LFTs
• Azoospermia
• Bone marrow suppression causing pancytopenia and immunosuppression

Question 7

What are the adverse side effects of leflunomide?

Answer 7

• Alopecia
• Hypertension
• Pneumonitis
• Peripheral neuropathy
• Hepatotoxicity
• Bone marrow suppression causing pancytopenia and immunosuppression

Question 8

What are examples of monoclonal antibodies?

Answer 8

• Infliximab
• Rituximab
• Adalimumab

Question 9

What is the main adverse effect of bisophosphonates?

Answer 9

Oesophagitis - advise to take 30 mins prior to breakfast, drink lots of water with it and sit up right.