Hydroxychloroquine retinopathy screening guidelines

Discussion in 'Canada Pharmacy Online' started by backup, 20-Mar-2020.

  1. gang100 Guest

    Hydroxychloroquine retinopathy screening guidelines


    "Look at everything—every time" is a mantra many of us have humming in the background as we go through our clinical day. Accordingly, providing screening examinations for high-risk medications, such as hydroxychloroquine, is a natural service for our profession.

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    Given the initial low risk of HCQ or CQ retinopathy, with a proper dose and in the absence of major risk factors, annual screening can be deferred until there has been 5 years of exposure. Screening should begin sooner if the risk is high Table 1. Background. The American Academy of Ophthalmology recommendations for screening of chloroquine CQ and hydroxychloroquine HCQ retinopathy were published in 2002, but improved screening tools and new knowledge about the prevalence of toxicity have appeared in the ensuing years. The American Academy of Ophthalmology released an updated set of screening recommendations for hydroxychloroquine Plaquenil and chloroquine to account for the many studies that have shown the effects of these medications on the retina 1. It succinctly makes the case for screening, and

    The retinopathy is hallmarked by parafoveal changes within the retina. Hydroxychloroquine is an analogue to the much older drug chloroquine. Hydroxychloroquine is most frequently used for the management of lupus and rheumatoid arthritis; however, it is now being applied to treatments in adjunctive cancer therapy, diabetes, and heart disease.

    Hydroxychloroquine retinopathy screening guidelines

    Hydroxychloroquine Plaquenil Toxicity and Recommendations., Revised Recommendations on Screening for Chloroquine and.

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  3. And screening tests, but that screening begins after one year of therapy for all patients on chloroquine. Screening may be best incorporated into the hospital eye service via virtual clinics. The results of screening should be communicated back to the prescribing doctor, patient and GP as normal, possible or definite hydroxychloroquine retinopathy.

    • Hydroxychloroquine and Chloroquine Retinopathy Recommendations on..
    • Hydroxychloroquine And Chloroquine Screening 2016 AAO Recommendations..
    • Hydroxychloroquine toxicity - EyeWiki.

    Guidelines on screening for retinopathy associated with hydroxychloroquine toxicity were initially published by the Academy in 2002. These guidelines were updated in February of this year, given the emergence of more sensitive diagnostic techniques and the recognition that risk of toxicity from years of hydroxychloroquine use is greater than. RESULTS AND DISCUSSION The risk of developing CQ or HCQ retinopathy depends on the daily dose and duration of treatment. At recommended doses, the risk is1 % at 5 years, 2 % at 10years but increases to about 20 % after 20years of treatment. The maximum recommended daily dose is 5.0mg/kg for HCQ and 2.3mg/kg for CQ. BACKGROUND The American Academy of Ophthalmology recommendations for screening of chloroquine CQ and hydroxychloroquine HCQ retinopathy were published in 2002, but improved screening tools and new knowledge about the prevalence of toxicity have appeared in the ensuing years.

     
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    400-600 mg (310-465 mg base) PO daily for 4-12 weeks; maintenance: 200-400 mg (155-310 mg base) PO daily With prolonged therapy, obtain CBCs periodically 400 mg (310 mg base) PO once or twice daily; maintenance: 200-400 mg (155-310 mg base) PO daily With prolonged therapy, obtain CBCs periodically 100-200 mg (77.5-155 mg base) PO 2-3 times/wk Take with food or milk Nausea, vomiting Headache Dizziness Irritability Muscle weakness Aplastic anemia Leukopenia Thrombocytopenia Corneal changes or deposits (visual disturbances, blurred vision, photophobia; reversible on discontinuance) Retinal damage with long-term use Bleaching of hair Alopecia Pruritus Skin and musculoskeletal pigmentation changes Weight loss, anorexia Cardiomyopathy (rare) Hemolysis (individuals with glucose-6-phosphate dehydrogenase (G-6-PD) deficiency) Prolongs QT interval Ventricular arrhythmias and torsade de pointes Vertigo Tinnitus Nystagmus Nerve deafness Deafness Irreversible retinopathy with retinal pigmentation changes (bull’s eye appearance) Visual field defects (paracentral scotomas) Visual disturbances (visual acuity) Maculopathies (macular degeneration) Decreased dark adaptation Color vision abnormalities Corneal changes (edema and opacities) Abdominal pain Fatigue Liver function tests abnormal Hepatic failure acute Urticaria Angioedema Bronchospasm Decreased appetite Hypoglycemia Porphyria Weight decreased Sensorimotor disorder Skeletal muscle myopathy or neuromyopathy Headache Dizziness Seizure Ataxia Extrapyramidal disorders such as dystonia Dyskinesia Tremor Rash Pruritus Pigmentation disorders in skin and mucous membranes Hair color changes Alopecia Dermatitis bullous eruptions including erythema multiforme Stevens-Johnson syndrome Toxic epidermal necrolysis Drug reaction with eosinophilia and systemic symptoms (DRESS syndrome) Photosensitivity Dermatitis exfoliative Acute generalized exanthematous pustulosis (AGEP); AGEP has to be distinguished from psoriasis; hydroxychloroquine may precipitate attacks of psoriasis Pyrexia Hyperleukocytosis Hypersensitivity to 4-aminoquinoline derivatives Retinal or visual field changes due to 4-aminoquinoline compounds Long-term therapy in children Not effective against chloroquine-resistant strains of P. Individual plans may vary and formulary information changes. Hydroxychloroquine Side Effects, Dosage, Uses, and More Hydroxychloroquine Information for Providers AIDSinfo Hydroxychloroquine - Wikipedia
     
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  6. Oleg-media Well-Known Member

    Methotrexate and plaquenil - @Kristinsaba1988. I had a biopsy and my doctor said he believes it is morphea. I am waiting on my blood test to come back and he said as soon as it does he will put me on both methotrexate and doctor is a very good derm.

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