Plaquenil retinal toxicity screening

Discussion in 'Pharmacy Northwest Canada' started by BrainDead, 17-Mar-2020.

  1. eviris XenForo Moderator

    Plaquenil retinal toxicity screening


    It succinctly makes the case for screening, and outlines the evidence for screening methods and parameters to know for screening. Because this information is pretty important (2), I wanted to highlight some of the key points made by the publication.

    Hydroxychloroquine and prednisone How can plaquenil scarring alopecia Atovaquone proguanil chloroquine doxycycline or mefloquine Plaquenil for lupus reviews

    Plaquenil Screening. Plaquenil hydroxychloroquine is a medication used to treat many rheumatologic diseases, including rheumatoid arthritis. Generally it is safe, but one of the side effects of Plaquenil is retinal toxicity. If retinal toxicity is not detected, and Plaquenil is continued, it can cause irreversible vision loss. In particular, chloroquine and hydroxychloroquine Plaquenil are two such medications, with the potential for retinal toxicity. Given that the retinal damage from these medications is largely irreversible, screening by a retinal specialist is critical to detect early retinal toxicity to try and limit the extent of visual loss. The American Academy of Ophthalmology has published several dosing and screening recommendations for hydroxychloroquine to avoid potential retinal toxicity, yet some patients still experience permanent vision loss resulting from hydroxychloroquine retinopathy due to improper dosing of the drug and improper screening.

    Visual fields and SD-OCT are not necessary for baseline measurements unless there is pre-existing retinal pathology that needs to be documented. I’m sure that this may continue to change and evolve the more we learn; but here are my conclusions: A comprehensive ophthalmology exam should be performed within 1 year of starting hydroxychloroquine or chloroquine.

    Plaquenil retinal toxicity screening

    Toxic Retinopathy With Hydroxychloroquine Therapy, Retinal Screening for Hydroxychloroquine Plaquenil Toxicity

  2. Plaquenil toenails
  3. Newer guidelines state that daily dose 5mg/kg of real weight/day can lead to toxicity. Retinal toxicity is irreversible and can progress after cessation of hydroxychloroquine, thus early screening is important to limit potential vision loss. Baseline screening and annual screening after five years is recommended.

    • Hydroxychloroquine Plaquenil Toxicity and Recommendations..
    • Despite Plaquenil dosing recommendations, retinal toxicity..
    • Hydroxychloroquine Retinopathy Still Alive and Well - The..

    Currently, one of the primary functional screening tests recommended for the evaluation of Plaquenil retinal toxicity is 10-2 white stimulus automated visual fields; however, research shows Asian patients benefited from 24-2 or 30-2 visual fields, given that toxicity often manifests changes beyond the macula in these patients. 9 Because spectral-domain optical coherence tomography SD-OCT is readily accessible and able to detect early structural damage prior to clinical funduscopic findings. Hydroxychloroquine Plaquenil, Sanofi-Aventis remains widely used in the treatment of various rheumatologic disorders. A small percentage of patients exposed to hydroxychloroquine will develop irreversible, and potentially progressive, retinal toxicity for which no effective treatment exists. One of the most important sites of potential HCQ toxicity is the retina. Early retinal toxicity, 7 characterized by paracentral scotoma, usually goes unnoticed by patients. However, more 8 advanced toxicity, characterized by foveal damage, is associated with paracentral and eventually 9 central vision loss.

     
  4. VictorT XenForo Moderator

    Applies to hydroxychloroquine: oral tablet Along with its needed effects, hydroxychloroquine (the active ingredient contained in Plaquenil) may cause some unwanted effects. Plaquenil Oral Uses, Side Effects, Interactions, Pictures. Common Paxil Side Effects You Should Know About Does anyone else feel worse on Plaquenil?
     
  5. mobistar Moderator

    Plaquenil is the brand name for the prescription drug hydroxychloroquine. Statins What happens to patients who stop taking them after. Taking Plaquenil for Rheumatoid Arthritis Which Supplements Should Be Avoided When Taking Statins.
     
  6. hrach Guest

    Guidelines for Treatment of Malaria in the United States. Infections should receive chloroquine prophylaxis 300 mg base po once a week during pregnancy.

    Chloroquine - FDA prescribing information, side effects.