Rheumatology
Caffeine may worsen rheumatoid arthritis
As a clinical pharmacist, you should always be aware of drug interactions. There's concern that caffeine might reduce the efficacy of methotrexate for rheumatoid arthritis ... Methotrexate decreases inflammation by increasing adenosine levels. Caffeine might cause a problem, because it's an adenosine receptor ANTAGONIST. It's goi…
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Steroids
Help patients stick with METHOTREXATE for rheumatoid arthritis
New guidelines will lead to questions about treating rheumatoid arthritis , especially with the plethora of medication options. For more information, see topic on Overview of rheumatoid arthritis . Which medication is first-line ? Recommend sticking with oral methotrexate 7.5 mg once weekly for most patients. Generally ad…
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Steroids
Identifying patients at risk for fractures due to chronic steroids
As a clinical pharmacist, it is important to address the therapy gap in preventing osteoporosis and fractures among patients on chronic corticosteroids. More than one in 10 patients using these medications long-term will experience a fracture as a result of glucocorticoid-induced osteoporosis. It is crucial for you as a pharmacist to be vigilant in identifying patien…
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Rheumatology
Overview of rheumatoid arthritis
E ssentials of diagnosis ㅡ Usually insidious onset with morning stiffness and joint pain. Symmetric polyarthritis with predilection for small joints of the hands and feet; deformities common with progressive disease and extra-articular manifestations. Rheumatoid factor and antibodies to cyclic citrullinated peptides (anti-CCP) are present in 70–80%.. Radiographic fi…
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Rheumatology
How to manage methotrexate in patients with rheumatoid arthritis (RA)?
As a clinical pharmacist, the first-line treatment for rheumatoid arthritis is usually methotrexate. It is often as effective as using a biologic medication alone and is generally considered safer. It is important to support patients in improving their ability to tolerate methotrexate so that they don't stop taking it unnecessarily. Dosage scenario of MTX…
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