Flash. MS. Disease Modifier AntiRheumatic Drugs (DMARDs)

DMARDs are primarily used to treat inflammatory rheumatic diseases like rheumatoid arthritis, slowing or halting disease progression.

Hydroxychloroquine has a risk of retinal toxicity.

Methotrexate inhibits the enzyme dihydrofolate reductase, leading to a decrease in DNA synthesis and inflammation.

Leflunomide can cause liver toxicity.

Regularly, often every 4-8 weeks initially, depending on the specific DMARD and patient's risk factors.

Patients starting on TNF inhibitors, such as etanercept or infliximab, often require screening for tuberculosis.

Methotrexate is teratogenic and can cause fetal harm.

Sulfasalazine is administered orally.

Patients should undergo an eye examination at baseline and regularly thereafter to monitor for retinal changes.

Methotrexate can lead to lung toxicity.

Hydroxychloroquine can cause photosensitivity.

TNF inhibitors suppress the immune system, potentially increasing the risk for bacterial, fungal, or viral infections.

They are administered as subcutaneous injections.

Many DMARDs can cause liver toxicity.

Methotrexate and hydroxychloroquine can both lead to hair loss.

Immediately upon noticing symptoms like persistent cough, yellowing of the eyes/skin, unusual fatigue, persistent nausea/vomiting, or other severe or unexpected symptoms.

Yes, often DMARDs are used in combination with other medications like NSAIDs or corticosteroids for better disease control.

Live vaccines should be avoided or used with caution, given the immunosuppressive nature of many DMARDs.

It can take weeks to months, depending on the drug and the individual's response.

Patients should be informed about potential side effects, the importance of regular monitoring and follow-up appointments, and the need to notify their healthcare provider about any unusual or severe symptoms.