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Rheumatic Disease Drugs (Hydroxychloroquine (SE (Visual change rarely…

- - - - Unknown MOA
    - - 5-Aminosalicylate
        
        SE
        
        blood dyscrasias
        
        hepatitis
        
        rash, urticaria
        
        oligospermia
        
        pulmonary fibrosis
        
        Caution in renal or
        hepatic impairment
        
        Monitor FBC
        Better for use in young women
        cf. methotrexate
- - - - BM suppression
        
        Pulmonary fibrosis
        
        Hepatotoxic
    - - Cancer
        RA
        Psoriasis
        Crohn’s
- - - - SE myelosuppression pancytopenia
    - - Sulfasalazine
        
        SJS
        
        pulmonary fibrosis
        
        ↓ sperm count
      - Hydroxychloroquine
        
        visual change
        
        rash
        
        seizures
      - Methotrexate
        
        hepatotoxic
        
        teratogenic
        
        pulm. fibrosis
    - - Leflunomide
        
        ↑ risk of infection and malignancy
      - Gold
        
        nephrotic syndrome
      - Penicillamine
        
        taste change
        
        nephrotic syndrome
        
        drug-induced lupus
  - - - Infliximab: chimeric anti-TNF Ab
      - Adalimumab: human anti-TNF Ab
      - Etanercept: TNF-receptor
      - Screen and Rx TB first
      - SEs
        
        ↑ Ca
        
        ↑ AI disease
        
        ↑ infection (sepsis, TB)
      - Severe RA not responding to DMARDs
        
        DAS28 >5.1
        
        Failed methotrexate + ≥1 other DMARD
    - - Severe RA not responding to anti-TNF therapy