Hydroxychloroquine and chloroquine retinopathy screening for drug toxicity

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  1. Alex-Job Well-Known Member

    Hydroxychloroquine and chloroquine retinopathy screening for drug toxicity


    She suffered from Sjogren syndrome and inflammatory arthritis and was currently treated with prednisone and methotrexate. She was previously treated with hydroxychloroquine (Plaquenil) 200mg bid (6.5mg/kg) for 10 years, which was stopped one year prior to presentation.

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    Macular toxicity is related to the total cumulative dose rather than the daily dose. Regular eye screening, even in the absence of visual symptoms, is recommended to begin when either of these risk factors occurs. Toxicity from hydroxychloroquine may be seen in two distinct areas of the eye the cornea and the macula. Chloroquine is a potent drug used for the treatment of various diseases, including malaria and a range of connective tissue disorders. Chloroquine retinopathy is an important complication that may appear even years after cessation of the drug, presenting with impaired visual acuity, central vision loss and progressive damage that could result in irreversible blindness. A detailed patient. Hydroxychloroquine and Ocular Toxicity Recommendations on Screening. The Royal College of Ophthalmologists in association with The British Society for Rheumatology and the British Association of Dermatologists, 2009.

    Review of systems: Blurred vision, halos, dry eye, dry mouth, gastroesophageal reflux, joint pain Pupils: Reactive to light in each eye from 5 mm in the dark to 2 mm in the light. Extraocular movements: Full, both eyes (OU) Confrontation visual fields: Full OU Intra-ocular pressure The optic nerves appeared healthy with a 0.3 cup-to-disc ratio. Past Ocular History: None Medical History: Sjogren syndrome and inflammatory arthritis, supraventricular tachycardia, anxiety, depression, peptic ulcer disease Medications: prednisone, methotrexate, amitriptyline, ranitidine, estradiol, tizanidine, diltiazem, Restasis Allergies: codeine, droperidol Family History: heart disease, arthritis, cancer Social History: occasional alcohol but no tobacco or intravenous drug use.

    Hydroxychloroquine and chloroquine retinopathy screening for drug toxicity

    Hydroxychloroquine Plaquenil Toxicity and Recommendations., Chloroquine Retinopathy Symptoms, Diagnosis and Treatment.

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  5. Many systemic medications may cause retinal toxicity. One such commonly used medication for dermatologic and rheumatologic inflammatory conditions is hydroxychloroquine Plaquenil, a chloroquine derivative. It is used to treat many diseases including malaria, rheumatoid arthritis and systemic lupus erythematosus.

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    Some patients, toxicity may first present as pericentral retinopathy and thus requires screening outside the macula. We assume chloroquine retinopathy follows a similar course as hydroxychloroquine retinopathy and so these guidelines also apply to patients taking chloroquine therapy. Recommendations on Screening for Chloroquine and Hydroxychloroquine Retinopathy A Report by the American Academy of Ophthalmology Michael F. Marmor, MD, Ronald E. Carr, MD, Michael Easterbrook, MD, Ayad A. Farjo, MD, William F. Mieler, MD, for the American Academy of Ophthalmology Introduction Retinal toxicity from chloroquine and its analogue, hy- Marmor MF, Kellner U, Lai TY, Melles RB, Mieler WF, American Academy of Ophthalmology. Recommendations on Screening for Chloroquine and Hydroxychloroquine Retinopathy 2016 Revision. Ophthalmology. 2016 Jun. 123 61386-94. Mason CG. Ocular accumulation and toxicity of certain systemically administered drugs.

     
  6. Shkaf Guest

    Yes, you've indicated side effects of Plaq, but they would usually not have occured so rapidly. Nausea from Plaquenil, etc" Lupus Community - Support Group Gastroscopy, have to stop medication 10 days before? - UK. Plaquenil What You Need to Know - Kaleidoscope Fighting Lupus
     
  7. CRIS Guest

    The resource you are looking for (or one of its dependencies) could have been removed, had its name changed, or is temporarily unavailable. Stomach problems with Plaquenil • Johns Hopkins Arthritis Center PATIENT FACT SHEET Hydroxychloroquine Plaquenil Plaquenil Side Effects Common, Severe, Long Term -
     
  8. Evgen123 Well-Known Member

    WHO Overview of malaria treatment Treatment of P. vivax infections. P. vivax infections should be treated with an ACT or chloroquine in areas without chloroquine-resistant P. areas where chloroquine-resistant P. vivax has been identified, infections should be treated with an ACT, preferably one in which the partner medicine has a long half-life.

    Medicines for the Prevention of Malaria While Traveling.