Rheumatology · Drug Selection, Screening Protocols, Monitoring Requirements, and Class-Specific Toxicity Recognition Across Seven Drug Classes
Rheumatology & MSK Pharmacology MS1/MS2 medical students This file is the pharmacology capstone integrating drug selection, screening protocols, monitoring requirements, and class-specific toxicity recognition across seven drug classes: (1) NSAIDs, (2) glucocorticoids, (3) conventional synthetic DMARDs (csDMARDs), (4) biologic and targeted synthetic DMARDs (bDMARDs/tsDMARDs), (5) urate-lowering therapy, (6) bone-targeting agents, (7) muscle relaxants. It applies Core Immunology File 10's drug mechanism layer to clinical selection in rheumatologic and MSK disease contexts.
Prerequisites MSK Anatomy, Histology, Embryology & Joint Biology (File 1) Bone & Cartilage Biology, Mineral Homeostasis (File 2) Approach to Inflammatory Arthritis & Rheumatoid Arthritis (File 3 — methotrexate first-line + biologic selection) Systemic Lupus Erythematosus & Mixed Connective Tissue Disease (File 4 — hydroxychloroquine universal + induction/maintenance for lupus nephritis) Seronegative Spondyloarthropathies (File 5 — anti-TNF and IL-17/IL-23 inhibitor selection) Sjögren's Syndrome, Scleroderma & Inflammatory Myopathies (File 6 — high-dose steroids + steroid-sparing agents) Vasculitides & Systemic Granulomatous Disease (File 7 — rituximab vs cyclophosphamide induction; tocilizumab in GCA) Monoarthritis: Crystal Arthropathies, Septic Arthritis & Osteoarthritis (File 8 — gout: colchicine, NSAIDs, steroid + ULT selection) Metabolic Bone Disease (File 9 — bisphosphonates, denosumab, teriparatide, romosozumab) Muscle & Neuromuscular Disease (File 11 — DMD glucocorticoids; dantrolene for malignant hyperthermia) Pediatric Rheumatology & MSK (File 12 — methotrexate, biologics, IVIG, anakinra for systemic-onset JIA and MAS) Soft Tissue Rheumatism, Fibromyalgia & MSK Manifestations of Systemic Disease (File 13 — fibromyalgia: TCAs/SNRIs/gabapentinoids; AVOID opioids/chronic NSAIDs) Core Immunology File 10 (drug mechanisms of immunosuppressants and biologics — NOT re-derived in this file)