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09 April 2024: Review Articles

A Review of the Current Status of Anesthetic Management of Patients with Rheumatoid Arthritis

Paweł Radkowski 123ABCDEFG , Maciej Szewczyk 4ABCDEFG* , Klaudia Sztaba 1F , Mariusz Kęska 12F

DOI: 10.12659/MSM.943829

Med Sci Monit 2024; 30:e943829

Table 2 Drugs adverse effects that can occur during treatment of rheumatoid arthritis.

DrugAdverse effects
NSAIDsDyspepsia, gastroduodenal ulcers and its complications (bleeding, perforation) tubulo-interstitial nephritis, type IV renal tubular acidosis and hyperkalemia hypertension, increased cardiovascular risk, elevated transaminases, slower bone regeneration
GlucocorticoidsOsteoporosis, enhancement of the pro-ulcer effects of NSAIDs, gastrointestinal bleeding, iatrogenic Cushing’s syndrome
csDMARDsMTXNausea, abdominal pain, diarrhea), rash/allergic reaction, bone marrow suppression, hepatotoxicityInterstitial lung disease, alopecia, folic acid deficiency, transaminitis
LeflunomideAlopecia, hypertension, peripheral neuropathy, weight loss
SulfasalazineFatigue, CNS reactions, panhypogammaglobulinemia
ChloroquineRetinopathy/maculopathy, rash, diarrhea
HydroxychloroquineAnemia, leukopenia, myopathy, and cardiomyopathy
Gold compoundsSkin lesions, anemia, leukopenia, thrombocytopenia, proteinuria
CyclosporinNephrotoxicity, hypertension
tsDMARDsTofacitinib, baricitinibInfections, embolism, thrombosis, elevation of blood cholesterol levels
bDMARDsTNF inhibitorsInfliximabInfections, non-melanoma skin cancers
EtanerceptInfections, headache, rhinitis
CertolizumabInfections, fatigue, mild skin rash
AdalimumabInfections, pneumonia, celulitis
IL-6 inhibitorsTocilizumabDyslipidemia, elevated levels of liver enzymes, cytopenias
B cell depletionRituximabInfections, infusion reactions, nervous system disorders, gastrointestinal disorders, psoriasis
Inhibitors of T-cell co-stimulationAbataceptUpper respiratory tract infections, headaches, and nausea
NSAIDs – nonsteroidal anti-inflammatory drugs; csDMARDs – conventional synthetic disease-modifying anti-rheumatic drugs; MTX – methotrexate; CNS – central nervous system; tsDMARDs – targeted synthetic disease-modifying anti-rheumatic drugs; bDMARDs – biological disease-modifying anti-rheumatic drugs; TNF – tumor necrosis factor; IL-6 –interleukin 6.

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750