Toxicity
Interactions
Infections
In Anagrams
Pregnancy
PharmacoGenomics
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PHOTOS
Long term use of this drug can
cause macular damage and
bluish discoloration of the skin.
Hydroxychloroquine
Baseline and q 3 mo LFTs and
CBC, a baseline chest x-ray and
Hep B and C screen are
recommended prior to starting
this drug.
Methotrexate
The use of this medication to
replace cyclosporin has helped
lessen the incidence of
hyperuricemia and gout among
transplant patients.
Mycophenolate mofetil
Use of cyclophosphamide can
lead to this kind of cancer
Bladder Cancer
PHOTO
Defieciency in this
immunoglobulin can lead to
severe anaphylactic reactions in
patients receiving IVIG. Check it
before the patient receives it.
IgA
The dose of Azathioprine should
be decreased by 50% when a
male patient with tophi is also
taking this drug.
POUR LION ALL
Allopurinol
This neurotransmitter is the
target of a class of
antidepressants which when
taken with NSAIDs can greatly
increase the risk of GI bleeding
by 30-50%.
NOTE IRONS
Serotonin
Even a 3-day course of Naproxen
can decrease the protein binding
of this drug which notoriously has
a very low therapeutic index,
greatly increasing the risk of GI
hemorrhage.
FAIR WARN
Warfarin
The use of a commonly used class of
antidepressants can greatly diminish
the analgesic effect of this pain
medication by inhibition of CYP2D6.
DRAMA LOT
Tramadol
Cyclosporine inhibits organic
anion transporting polypeptide
(OATP) transporters, a family of
influx transporters, which is the
substrate for a commonly used
lipid-lowering agent which has
also been implicated in causing
myopathy.
VITAMINS SAT
Simvastatin
A patient who works in a hospital
and nursing home who develops
septic arthritis or bursitis should
be started on this antibiotic.
Vancomycin
Use of Rituxan has been
associated with this kind of
infection due to the JC Virus
Progressive multifocal
leukoencephalopathy
Of Hepatitis B or C, the use of
Rituximab should be used with
great caution.
Hepatitis B
Of Infliximab, Abatacept, and
Rituximab, reactivation of this
infection can is strongly
associated with the use of this
biologic agent.
Tuberculosis
This condition should be
considered in an RA patient from
Arizona on a biologic agent who
develops fevers, cough and lung
lesions.
Coccidiodomycosis
Patients who have been on
Leflunomide who are seeking to
conceive should receive this
medication in order to rid the body
of the medication
Cholestyramine
Of A, B, C, D – the FDA
pregnancy category for
Hydroxychloroquine
B
This is the FDA Pregnancy
category for Methotrexate.
Class D
Of 20%, 40%, 60% - the
approximate percentage of fetal
deaths that can occur with usage
of Mycophenolate mofetil
40%
Fetal loss can be prevented in
women with this disease by using
SQ Heparin.
Antiphospholipid Antibody
Syndrome
Alterations in P450 3A activity in
liver, especially CYP3A4 and CYP3A5,
and intestinal P-glycoprotein (P-gp)
concentration are important factors
in the metabolism of this drug.
Cyclosporin
Reduced activity of this enzyme
can cause increased GI side
effects and hepatotoxicity, lupuslike syndromes and cutaneous
vasculitis with patient taking
sulfasalazine. It is the same
enzyme that metabolizes
Isoniazid.
Sulfasalazine
The risk for GI hemorrhage with
use of celecoxib, diclofenac,
indomethacin, naproxen and
piroxicam is associated with
activity of this cytochrome.
CYP2C9
Talk about the 40s! There is a 40%
incidence of deficiency in this
enzyme which metabolizes
Methotrexate; a CT heterozygote for
the C677T genotype is found in 40%
of the population is associated with
a 40% inability to regenerate one of
the elements in the metabolic
pathyway.
Methyltetrahydrofolate
reductase
Deficiency in this enzyme can
lead to leukopenia in patients
taking Azathioprine
PLEASE ReFUSE HIM THe
TYRANNY RIOT LR
TPMT or
Thiopurinylmethyltransferase