Question

Anti-rheumatoid drug which is contraindicated in patients with renal and hepatic impairment

• A. Sulfasalazine
• B. Methotrexate
• C. Corticosteroids
• D. Azathoprine

Answer 1

The Correct Option is B

The question asks to identify an anti-rheumatoid drug that is contraindicated in patients with renal and hepatic impairment. Let's evaluate each option:

• Sulfasalazine: This drug is used to treat rheumatoid arthritis, but it is generally considered safer in patients with renal impairment compared to methotrexate. However, it still requires cautious use in severe hepatic impairment.
• Methotrexate: This is a folate antagonist used widely in the treatment of rheumatoid arthritis. Methotrexate is contraindicated in patients with severe renal and hepatic impairment. The drug relies heavily on renal excretion, and impaired kidney function can lead to toxic accumulation. Similarly, methotrexate is hepatotoxic and can lead to liver dysfunction, worsening any pre-existing hepatic conditions.
• Corticosteroids: These are often used to manage inflammation in rheumatoid arthritis. While they require cautious use and monitoring in patients with renal and hepatic impairment, they are not outright contraindicated like methotrexate.
• Azathioprine: This immunosuppressant can be used in rheumatoid arthritis management, but similar to corticosteroids, it requires caution and potential dose adjustment in renal and hepatic impairment, not outright contraindication.

Based on the explanations above, Methotrexate is the correct answer, as it is contraindicated in significant renal and hepatic impairment due to its mechanism of excretion and potential hepatotoxicity.