Question

Please provide reference to each question

4.         Mary has been taking methotrexate for about 4 months (along with naproxen as needed). She is currently taking 15mg weekly but her RA is not under control yet and she been feeling really rough the past few days with a sore throat and a cough developing. It’s the weekend and she can’t reach her rheumatologist so she stops at your pharmacy. Should she stop taking MTX?

5.         Mary (above) is taking irregular doses of naproxen with her methotrexate. Is that a problem? If so, how should it be managed?

                                   

6.         You have a patient in the pharmacy who just began her first prescription for a biologic (Actemra). She asks how quickly it will work. She is also very worried about the risks of medication itself, whether she will run out of options to control her disease, and if she must be on medication for life. Please describe the information you will give to counsel her, both to make her well informed and to calm her fears.

7.         Assume you have a patient who originally had mild RA for two years. She has taken methotrexate and etanercept for one year and been in full remission now for 6 months. Should we stop her drug treatment? What exactly should you recommend?

8.         Another patient was on methotrexate orally, but now her doctor wants to switch to the injection form and the patient is upset about it. What are the possible advantages to sc. injection

Answer 1

4. She can stop the MTX abruptly and no side effects of it and than meet up the doctor for her symptoms as it take six week of the MTX to show its effects when taking.

5. Naproxon may increase the blood levels and side effects of the methotrexate. The risk is less if patients take MTX once a week. When combining both the medications it has to be closely monitored by the physicians.

6. Actemra is an immunosupresant drug which is taken for the severe arthritis. It may take about 2 to 12 weeks to act accordingly.