09 April 2024 : Review article
A Review of the Current Status of Anesthetic Management of Patients with Rheumatoid Arthritis
Paweł Radkowski
123ABCDEFG, Maciej Szewczyk 4ABCDEFG*, Klaudia Sztaba 1F, Mariusz Kęska 12F
DOI: 10.12659/MSM.943829
Med Sci Monit 2024; 30:e943829
Table 2 Drugs adverse effects that can occur during treatment of rheumatoid arthritis.
| Drug | Adverse effects | |||
|---|---|---|---|---|
| NSAIDs | Dyspepsia, gastroduodenal ulcers and its complications (bleeding, perforation) tubulo-interstitial nephritis, type IV renal tubular acidosis and hyperkalemia hypertension, increased cardiovascular risk, elevated transaminases, slower bone regeneration | |||
| Glucocorticoids | Osteoporosis, enhancement of the pro-ulcer effects of NSAIDs, gastrointestinal bleeding, iatrogenic Cushing’s syndrome | |||
| csDMARDs | MTX | Nausea, abdominal pain, diarrhea), rash/allergic reaction, bone marrow suppression, hepatotoxicity | Interstitial lung disease, alopecia, folic acid deficiency, transaminitis | |
| Leflunomide | Alopecia, hypertension, peripheral neuropathy, weight loss | |||
| Sulfasalazine | Fatigue, CNS reactions, panhypogammaglobulinemia | |||
| Chloroquine | Retinopathy/maculopathy, rash, diarrhea | |||
| Hydroxychloroquine | Anemia, leukopenia, myopathy, and cardiomyopathy | |||
| Gold compounds | Skin lesions, anemia, leukopenia, thrombocytopenia, proteinuria | |||
| Cyclosporin | Nephrotoxicity, hypertension | |||
| tsDMARDs | Tofacitinib, baricitinib | Infections, embolism, thrombosis, elevation of blood cholesterol levels | ||
| bDMARDs | TNF inhibitors | Infliximab | Infections, non-melanoma skin cancers | |
| Etanercept | Infections, headache, rhinitis | |||
| Certolizumab | Infections, fatigue, mild skin rash | |||
| Adalimumab | Infections, pneumonia, celulitis | |||
| IL-6 inhibitors | Tocilizumab | Dyslipidemia, elevated levels of liver enzymes, cytopenias | ||
| B cell depletion | Rituximab | Infections, infusion reactions, nervous system disorders, gastrointestinal disorders, psoriasis | ||
| Inhibitors of T-cell co-stimulation | Abatacept | Upper respiratory tract infections, headaches, and nausea | ||
| NSAIDs – nonsteroidal anti-inflammatory drugs; csDMARDs – conventional synthetic disease-modifying anti-rheumatic drugs; MTX – methotrexate; CNS – central nervous system; tsDMARDs – targeted synthetic disease-modifying anti-rheumatic drugs; bDMARDs – biological disease-modifying anti-rheumatic drugs; TNF – tumor necrosis factor; IL-6 –interleukin 6. | ||||