Oct appearance of plaquenil toxicity

Discussion in 'Chloroquine Drug' started by Crash_18, 29-Feb-2020.

  1. vs Well-Known Member

    Oct appearance of plaquenil 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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    On examination, a telltale sign of hydroxychloroquine toxicity is a bilateral change in the retinal pigment epithelium of the macula that gives the commonly described appearance of a bull’s-eye. This is a late finding, however, and too late for screening to be useful. OCT scan top of normal macula compared to Plaquenil Toxicity bottom with loss of the outer retinal tissue around the macular center red boxes View more retina images at Retina Rocks, the world’s largest online multimedia retina image library and bibliography repository. Plaquenil toxicity first affects small areas of the retina between 5° and 15° from the fovea. Figures 2 and 3 show three patients at different stages of toxicity. Figure 2 bottom right shows a color display of normal mfERGs. The amplitude of the mathematically derived b-wave of the mfERG is displayed in a color scale.

    It is imperative that patients and physicians are aware of and watch for this drug’s ocular side effects. Retinal toxicity from hydroxychloroquine is rare, but even if the medication is discontinued, vision loss may be irreversible and may continue to progress.

    Oct appearance of plaquenil toxicity

    Protecting your eyesight when taking Plaquenil Lupus., Plaquenil Toxicity - Bennett & Bloom Eye Centers

  2. Plaquenil children
  3. Of course the aim is avoid drug related retinal toxicity, which on ophthalmic examination, appears as the classic Bull’s eye change affecting the macula. Once retinal toxicity from hydroxychloroquine occurs, it is thought that the retinal changes are permanent and the disease can progress even if hydroxychloroquine is stopped for 1 to 3 years.

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    In early cases of Plaquenil toxicity, an early indicator of damage is the appearance of a paracentral scotoma seen on automated visual field testing in the absence of fundus changes. 18 Each of the testing strategies can be used to detect early toxicity changes, but the presentation of the visual field effects will vary. Due to the central area being depressed in the 24-2 and 30-2 testing strategies, it is difficult to discern the central 2-degree field of sparing seen in the 10-2 tests. SD-OCT Unlike time domain optical coherence tomography, SD-OCT has the resolution to detect localized thinning of the retina in the parafoveal region. On SD-OCT, loss or thinning of the parafoveal and perifoveal photoreceptor layer and focal disruption of outer segment laminations are consistent with toxicity 13. 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.

     
  4. akyn Guest

    Most individuals with G6PD deficiency are asymptomatic. Autoimmune Hemolytic Anemia What You Should Know Autoimmune hemolytic anemia - Wikipedia Published Reports of Delayed Hemolytic Anemia After Treatment.
     
  5. cyber_cowboy New Member

    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 Sulfate Rash Reports - DrugInformer Plaquenil hydroxychloroquine sulfate dose, indications. DailyMed - HYDROXYCHLOROQUINE SULFATE tablet, film coated
     
  6. maxp Guest

    Taking Plaquenil for Rheumatoid Arthritis Plaquenil is a DMARD which has been prescribed for years to treat rheumatoid arthritis, lupus, juvenile rheumatoid arthritis, and other autoimmune diseases. When the first biologic DMARD received FDA-approval in 1998, and as other biologics followed in subsequent years, it appeared as though Plaquenil would become less prescribed.

    Rheumatoid Arthritis Drugs Demystifying DMARDs