Follow up question regarding the psoriatic arthritis patient started on the medication in question.
Which of the following are Implicated in a higher risk of ocular related toxicity to Hydroxychloroquine ?
1: Age greater than 60
2: total daily dose of > 400 mg per day
3: usage of the medication for more than 5 years or total cumulative dose of >1000 grams
4: A pre existing history of retinal
Or macular disease
5: Rapid weight loss on this medication
6: A previous history or liver or renal disease
7: Options 2,3, and 4
8: All options except for number 5
9: All of the above are correct.
Post your answers and explanations.
Thank you for your input
Answer:
All of the above.
A dose of >6.5 mg/kg, advanced age, or renal or liver disease (drug clearance) as well as a rapid weight loss on a fixed dose (higher mg/kg dose) have all been implicated in the development of toxicity.
Hydroxychloroquine is a milder immunosuppressant and commonly used. Be mindful of the major side effects, and remember not to fixate on only this side effect. Test writers know that most of you now know about retinitis from this medication.
Did you also know that blurry vision is much more commonly reported? This is due to an accommodation defect.
Hydroxychloroquine:
1: Eye exam before starting and surveillance Optho eval
2: be mindful of weight loss and other risk factors for ocular complications
3: some of the more common side effects are QT prolongation (test writers love to ask about medications that do this) abdominal pain (non specific so likely won’t be tested) and anorexia.
Good luck with your studying