Antirheumatoid Drugs
TERMS
□ hydroxychloroquine (Plaquenil)
□ methotrexate (Rheumatrex)
□ aurothioglucose (Solganal)
QUICK LOOK AT THE CHAPTER AHEAD
Although nonsteroidal anti-inflammatory drugs (NSAIDs) are used in treatment of rheumatoid arthritis, the antirheumatoid drugs have different effects. Antirheumatoid drugs, in addition to their anti-inflammatory and antiarthritic effects, also have immunomodulating effects, which prevent the movement of various cells into inflamed, damaged areas.1 This halts the progression of the disease and reduces inflammatory symptoms.
Antirheumatoid drugs are also known as disease-modifying antirheumatoid drugs (DMARD). They have a slow onset of action and are generally given over long periods of time.
Table 37-1 Antirheumatoid Drugs | |||||||||||||||||||||||||||
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Antirheumatoid Drugs Client Teaching
Antirheumatoid drugs are generally given until remission, followed by maintenance doses indefinitely.
Take antirheumatoids as prescribed and consult with health care provider before taking OTCs or herbal products.
Use sunscreen and protective clothing to prevent photosensitivity reactions.
Use a soft toothbrush to brush teeth.
Avoid use of antirheumatoid agents during pregnancy and lactation.
Periodic laboratory tests are indicated to monitor for side effects of antirheumatoids, including liver and renal function studies, CBC, and platelets.
Report symptoms of upper respiratory infection, sore throat, fever, bleeding/bruising, dyspnea, wheezing, or cough to health care provider.
Monitor for skin reactions such as rash, dermatitis, pruritus, stomatitis, and report to health care provider.
Periodic laboratory tests are indicated to monitor for side effects of antirheumatoids, including liver and renal function studies, CBC, and platelets.
Report symptoms of upper respiratory infection, sore throat, fever, bleeding/bruising, dyspnea, wheezing, or cough to health care provider.Hydroxychloroquine (Plaquenil)
Baseline and periodic ophthalmic exams.
Baseline and periodic ophthalmic exams.Penicillamine (Cuprimine)
Taste acuity may be altered.
Taste acuity may be altered.Methotrexate (Rheumatrex), Etanercept (Enbrel), Leflunomide (Arava), adalimumab (Humira), anakinra (Kineret)
Avoid vaccinations with live vaccines during therapy.
Avoid vaccinations with live vaccines during therapy.Leflunomide (Arava)
May cause dizziness and clients should avoid activities requiring alertness (driving, operating heavy machinery) until reaction to drug is known
May cause dizziness and clients should avoid activities requiring alertness (driving, operating heavy machinery) until reaction to drug is known
ACTIONDisease-Modifying Antirheumatic Drugs
Hydroxychloroquine (Plaquenil)
Antimalarial agent, with anti-inflammatory effects. The exact action is unknown. It may take up to 6 months to see therapeutic effects.
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