Docmoates: Add medication infobox (Drugbox) to monographs

2026-06-17T16:09:19Z

Add medication infobox (Drugbox) to monographs

← Older revision		Revision as of 16:09, 17 June 2026
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			{{Drugbox
			\| name = Conventional DMARDs (hydroxychloroquine, sulfasalazine, leflunomide)
			\| brand = Plaquenil, Azulfidine, Arava
			\| therapeutic = Disease-modifying antirheumatic drugs
			\| pharmacologic = Antimalarial (hydroxychloroquine), aminosalicylate (sulfasalazine), pyrimidine synthesis inhibitor (leflunomide)
			\| onset = Effect over weeks to months.
			\| halflife = Leflunomide very long (active metabolite); no routine level.
			\| routes = PO (oral)
			\| highalert = No
			\| blackbox = <span style="color:#b00020;">'''Yes'''</span> (see Safety)
			\| antidote = Cholestyramine washout for leflunomide; supportive care.
			\| pregnancy = Leflunomide contraindicated; hydroxychloroquine often continued in lupus pregnancy.
			}}

	<div style="border-left:4px solid #3f6f5b;background:#f3f6f4;padding:8px 12px;margin-bottom:12px;font-size:0.95em;">		<div style="border-left:4px solid #3f6f5b;background:#f3f6f4;padding:8px 12px;margin-bottom:12px;font-size:0.95em;">
	''Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and '''must be verified against current manufacturer labeling before clinical use'''. This is educational content, not prescribing guidance.''		''Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and '''must be verified against current manufacturer labeling before clinical use'''. This is educational content, not prescribing guidance.''

Docmoates: NCLEX nursing pharmacology monographs — batch import

2026-06-17T14:05:32Z

NCLEX nursing pharmacology monographs — batch import

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<div style="border-left:4px solid #3f6f5b;background:#f3f6f4;padding:8px 12px;margin-bottom:12px;font-size:0.95em;">
''Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and '''must be verified against current manufacturer labeling before clinical use'''. This is educational content, not prescribing guidance.''
</div>

'''Conventional DMARDs (hydroxychloroquine, sulfasalazine, leflunomide)''' (brand names Plaquenil, Azulfidine, Arava) — Disease-modifying antirheumatic drugs; Antimalarial (hydroxychloroquine), aminosalicylate (sulfasalazine), pyrimidine synthesis inhibitor (leflunomide).

== Identification ==
* '''Therapeutic class:''' Disease-modifying antirheumatic drugs.
* '''Pharmacologic class:''' Antimalarial (hydroxychloroquine), aminosalicylate (sulfasalazine), pyrimidine synthesis inhibitor (leflunomide).

== Pharmacology ==
* '''Mechanism of action:''' Each reduces immune-mediated inflammation by a distinct mechanism.
* '''Onset / peak / duration:''' Effect over weeks to months.
* '''Half-life / therapeutic level:''' Leflunomide very long (active metabolite); no routine level.

== Clinical use ==
* '''Indications:''' Rheumatoid arthritis, lupus (hydroxychloroquine), inflammatory bowel disease and rheumatoid arthritis (sulfasalazine).
* '''Usual dose, route, frequency:''' PO daily or divided.
* '''Maximum dose / adjustments:''' Hydroxychloroquine dosed by ideal body weight (retinal toxicity); leflunomide caution in hepatic disease.

== Safety ==
* '''Contraindications:''' Hydroxychloroquine with retinal disease; sulfasalazine with sulfa allergy; leflunomide in pregnancy and significant hepatic disease.
* '''Black box warning:''' Leflunomide carries boxed warnings for hepatotoxicity and embryo-fetal toxicity (a drug elimination procedure with cholestyramine is needed because of its long half-life).
* '''Interactions:''' Hydroxychloroquine with QT-prolonging drugs and digoxin; sulfasalazine with folate (reduced); leflunomide with hepatotoxic drugs.
* '''Pregnancy / lactation:''' Leflunomide contraindicated; hydroxychloroquine often continued in lupus pregnancy.
* '''High-alert:''' No.

== Adverse effects ==
* '''Common side effects:''' GI upset; sulfasalazine causes orange-yellow discoloration of urine and skin; hydroxychloroquine nausea.
* '''Serious effects to report:''' Hydroxychloroquine retinopathy (vision changes), sulfasalazine blood dyscrasias and hemolysis (G6PD), leflunomide hepatotoxicity.
* '''Antidote / reversal:''' Cholestyramine washout for leflunomide; supportive care.

== Nursing process ==
* '''Assessment before administration:''' Baseline eye exam (hydroxychloroquine), CBC and LFTs, sulfa allergy, pregnancy status.
* '''Interventions during therapy:''' Schedule eye exams (hydroxychloroquine); monitor liver and counts.
* '''Monitor:''' Vision (hydroxychloroquine), CBC, LFTs.
* '''Evaluation / expected outcome:''' Reduced disease activity.

== Patient teaching ==
* '''Patient teaching:''' Report vision changes (hydroxychloroquine); harmless orange-yellow color (sulfasalazine); reliable contraception (leflunomide).
* '''Notify provider if:''' Vision or color changes, fever or bruising, yellowing of skin.
* '''Administration tips:''' Take with food; keep eye exam schedule.

[[Category:Conventional DMARDs]]

Conventional DMARDs (hydroxychloroquine, sulfasalazine, leflunomide) - Revision history

Docmoates: Add medication infobox (Drugbox) to monographs

Docmoates: NCLEX nursing pharmacology monographs — batch import