Preg B, trimester Half-life 7.5 -14 hrs Fever, rash and elevated PD: block cyclooxygenase LFT’s specific and inhibit prostaglandin Hold if active infection production to produce inflammatory effects Corticosteroids oral Hypertension, B/P, CMP, DXA B/P, weight gain, SOB, Urinalysis for glucose DOSE: < or = to 10mg hyperglycemia polyuria, polydipsia, yearly of prednisone or Increases risk for shingles edema, visual changes Preg B equivalent QD. Should only Increases risk for infection be used for flares and Increase risk for bridging therapy osteoporosis PK: liver, CYP450:3A4 Increase risk for cataracts substrate Mood alteration Half-life varies on drug Weight gain PD: possibly inhibits Adrenal insufficiency cytokines Leflunomide Myelosuppression, Screening for Hep B & C Symptoms of CBC, Creatinine, liver DOSE 10-20mg per day Increase risk for infection to start. myelosuppression enzymes every 8 to 12 PK: liver, GI tract, CYP450 Increase risk for shingles weeks (q 2 months) Half life 15 -18 days Hold if active infection Preg X PD: inhibits pyimidine synthesisvia dihydroorotate dehydrogenase inhibition, resulting in immunomodulatory and antiproliferative activity Methotrexate Myelosuppression, hepatic CBC, Hepatitis B and C Symptoms of CBC and platelet count Oral or SQ toxicity and/or fibrosis, serology, LFT;s albumin, myelosuppression, SOB, LFT’s, Creatinine and DOSE: titrated by cirrhosis, pulmonary bilirubin and creatinine. N/V, oral ulcers, hair loss. albumin Q 8 weeks. symtpoms and labs. Usual infiltrates/fibrosis Chest Xray with in the last Monitor for infection start dose is 7.5mg to 10 Increase risk for infection year Preg X Increase risk for shingles TB test
Half-life 7.5 -14 hrs PD: block cyclooxygenase and inhibit prostaglandin production to produce effects Fever, rash and elevated LFT’s Hold if active infection Preg B, trimester specific Corticosteroids oral DOSE: < or = to 10mg of prednisone or equivalent QD. Should only be used for flares and bridging therapy PK: liver, CYP450:3A4 substrate Half-life varies on drug PD: possibly inhibits inflammatory cytokines Hypertension, hyperglycemia Increases risk for shingles Increases risk for infection Increase risk for osteoporosis Increase risk for cataracts Mood alteration Weight gain Adrenal insufficiency B/P, CMP, DXA B/P, weight gain, SOB, polyuria, polydipsia, edema, visual changes Urinalysis for glucose yearly Preg B Leflunomide DOSE 10-20mg per day PK: liver, GI tract, CYP450 Half life 15 -18 days PD: inhibits pyimidine synthesisvia dihydroorotate dehydrogenase inhibition, resulting in immunomodulatory and antiproliferative activity Myelosuppression, Increase risk for infection Increase risk for shingles Hold if active infection Screening for Hep B & C to start. Symptoms of myelosuppression CBC, Creatinine, liver enzymes every 8 to 12 weeks (q 2 months) Preg X Methotrexate Oral or SQ DOSE: titrated by symtpoms and labs. Usual start dose is 7.5mg to 10 Myelosuppression, hepatic toxicity and/or fibrosis, cirrhosis, pulmonary infiltrates/fibrosis Increase risk for infection Increase risk for shingles CBC, Hepatitis B and C serology, LFT;s albumin, bilirubin and creatinine. Chest Xray with in the last year TB test Symptoms of myelosuppression, SOB, N/V, oral ulcers, hair loss. CBC and platelet count LFT’s, Creatinine and albumin Q 8 weeks. Monitor for infection Preg X
Appendix%201-AutoImmune%20drug%20list.docx