Immunosuppressive and disease-modifying therapies used in rheumatologic conditions are associated with distinct adverse effect profiles requiring specific monitoring strategies. Match each medication below with its most characteristic adverse effect profile.
- HydroxychloroquineIrreversible macular toxicity necessitating baseline and periodic visual field testing
- CyclophosphamideAcrolein-mediated hemorrhagic cystitis and an elevated risk of transitional cell carcinoma
- InfliximabImpaired granuloma maintenance leading to reactivation of latent tuberculosis
- MethotrexateHepatic fibrosis, myelosuppression, and oral ulcers mitigated by folic acid
Answer
Hydroxychloroquine matches with macular toxicity; Cyclophosphamide matches with acrolein-mediated hemorrhagic cystitis; Infliximab matches with reactivation of latent tuberculosis; Methotrexate matches with hepatic fibrosis and oral ulcers.
The correct pairings align each rheumatologic medication with its most distinct and highly tested adverse effect, which directly informs the required clinical monitoring (e.g., ophthalmologic exams for hydroxychloroquine, TB testing for infliximab, mesna for cyclophosphamide, and folate supplementation for methotrexate).
Step-by-Step Solution
Key Concept
Adverse effect profiles and monitoring requirements of disease-modifying antirheumatic drugs (DMARDs) and biologic agents.