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Table 1: Pharmacological therapy, secondary and adverse effects. |
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Drug |
Indications |
Mechanisms of injury |
Alterations and metabolic and cardiovascular risks |
|
Nonsteroidal anti-inflammatory drugs |
All inflammatory diseases |
Direct endothelial damage, decreased nitric oxide and bleeding |
Arterial hypertension MI, CVE, AF, HF |
|
Glucocorticoids |
Inhibition of the hypothalamic-pituitary-adrenal axis, premature atherosclerosis, water retention, insulin resistance |
Osteoporosis, obesity, high blood pressure, MI, CVE, HF, arrhythmias (AF, flutter), DVT, PE |
|
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Antimalarials drugs (hydroxychloroquine) |
SLE, RA, SS |
QT prolongation, electrolyte imbalances |
Arrhythmias (torque de pointes, ventricular tachycardia), cardiotoxicity |
|
Cyclophosphamide |
SLE, SSc |
Direct drug toxicity |
Cardiotoxicity, premature ovarian failure, cytopenias |
|
Metotrexato |
RA, myopathies SS, SLE, TA |
Increased LDL, hyperhomocysteinemia, folate inhibitor |
Elevated liver enzymes, exacerbation of rheumatic nodules, nephropathy, hypercholesterolemia |
|
Anti-CD20 (rituximab) |
SLE, SS |
Ventricular remodeling |
HF |
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JAK inhibitors (baricitinib, tofacitinib) |
SLE, RA |
Hypercoagulability |
MI, CVE, DVT, PE, hypercholesterolemia |
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Anti-TNF alfa (etanercept, infliximab) |
RA, TA |
Left ventricular dysfunction |
HF worsening |
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MI = myocardial infarct. CVE = cerebral vascular event. AF = atrial fibrillation. DVT = deep vein thrombosis. PE = pulmonary thromboembolism. SLE = systemic lupus erythematosus. RA = rheumatoid arthritis. SS = Sjogren’s syndrome. SSc = systemic sclerosis. TA = Takayasu arthritis. HF = heart failure. |
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