more rheumatology at Royal

The first line DMARD drugs doctors try to use or almost either Methotrexate or Sulfasalazine. If these fail (after increasing their dose or trying 2nd line drugs like Hydroxychloroquine), then anti-TNF blockers are used.

The anti-TNF blockers are all given via injections. Infliximab IV while Etanercept and Adulimumab are s/c. (Man, all this while I thought they were oral drugs )

Follow up bloods to check in rheumatology patients:

1) FBC --> Methotrexate causes immunosuppression

2) U&Es --> DMARDs are notorious for causing renal impairment.

With methotrexate, one should co-prescribe folic acid to prevent folic acid deficiency.

RA nodules are only seen in seropositive patients

A joint aspiration should be performed before any antibiotics are given