From the Guidelines
A teaching plan for a patient with rheumatoid arthritis prescribed Plaquenil should include comprehensive medication education and disease management strategies, emphasizing the importance of regular ophthalmology appointments every 6-12 months to monitor for rare retinal toxicity, as recommended by recent guidelines 1. When creating a teaching plan for a patient with rheumatoid arthritis prescribed Plaquenil, it is essential to include information on the proper administration of the medication, potential side effects, and the importance of regular monitoring.
- The patient should be instructed to take Plaquenil with food to reduce stomach upset, as this can help minimize gastrointestinal side effects.
- Regular ophthalmology appointments every 6-12 months are crucial to monitor for rare retinal toxicity, a potential side effect of Plaquenil.
- The teaching plan should also cover joint protection techniques, balanced rest and exercise, and the use of hot/cold therapy for pain management, as these can help alleviate symptoms and improve quality of life.
- Additionally, the patient should be educated on the importance of medication adherence, even when feeling better, as Plaquenil helps prevent joint damage and disease progression.
- Potential side effects such as nausea, diarrhea, headache, and skin rashes should be discussed, and the patient should be advised to report severe symptoms or visual changes immediately.
- The patient should be informed that Plaquenil works by modulating the immune system to reduce inflammation, which helps control the autoimmune response causing joint damage in rheumatoid arthritis.
- Guidance on regular laboratory monitoring should also be provided to assess medication effectiveness and potential side effects on liver and kidney function, as recommended by recent guidelines 1. In terms of specific recommendations,
- b. Ophthalmology exam every 6 months is a crucial component of the teaching plan, as it can help detect rare retinal toxicity early on.
- c. You may experience a loss of balance while taking this drug is also an important consideration, as Plaquenil can cause dizziness or lightheadedness in some patients. However,
- a. If your pain is not alleviated in one week call the office may not be the most accurate recommendation, as Plaquenil can take 2-6 months to become fully effective.
- d. Always take this medication on an empty stomach is not recommended, as taking Plaquenil with food can help reduce stomach upset.
- e. Avoid alcohol consumption may be a general recommendation for patients with rheumatoid arthritis, but it is not specifically related to Plaquenil use.
From the FDA Drug Label
Important Administration Instructions Advise the patient to take hydroxychloroquine sulfate tablets with food or milk and not to crush or divide the tablet. Cardiomyopathy and Ventricular Arrhythmias Inform the patient that serious cardiac effects, life-threatening and fatal cases have been reported with use of hydroxychloroquine sulfate Measure liver tests promptly in patients who report symptoms that may indicate liver injury, such as fatigue, rash, nausea, dark urine, or jaundice. Warn hydroxychloroquine sulfate-treated patients about the risk of hypoglycemia and educate them on the signs and symptoms of hypoglycemia; diabetic patients should monitor their blood sugar levels.
The teaching plan for a patient diagnosed with rheumatoid arthritis and prescribed Plaquenil (hydrochloroquine sulfate) should include:
- Taking the medication with food or milk to minimize gastrointestinal side effects
- Not crushing or dividing the tablet to ensure proper absorption
- Monitoring for signs of liver injury, such as fatigue, rash, nausea, dark urine, or jaundice
- Being aware of the risk of hypoglycemia and monitoring blood sugar levels if diabetic
- Ophthalmology exam every 6 months is not directly mentioned in the provided drug labels, but it is a common recommendation for patients taking hydroxychloroquine sulfate to monitor for potential retinal toxicity.
- Avoiding alcohol consumption is not directly mentioned in the provided drug labels as a specific instruction for patients taking hydroxychloroquine sulfate, but it is generally recommended to avoid excessive alcohol consumption when taking any medication. The following options are not directly supported by the provided drug labels:
- If your pain is not alleviated in one week call the office
- You may experience a loss of balance while taking this drug
- Always take this medication on an empty stomach 2
From the Research
Teaching Plan for Rheumatoid Arthritis Patient Prescribed Plaquenil (Hydrochloroquine Sulfate)
The following points should be included in the teaching plan:
- Importance of regular ophthalmology exams: The patient should be informed about the need for regular ophthalmology exams, ideally every 6 months, to monitor for potential retinopathic adverse effects associated with hydroxychloroquine therapy 3, 4.
- Potential side effects and management: The patient should be educated about potential side effects, such as loss of balance, and how to manage them 3.
- Medication administration: The patient should be instructed to take the medication with food to minimize gastrointestinal side effects, contrary to option d which suggests taking it on an empty stomach 3.
- Importance of adherence to treatment: The patient should be encouraged to adhere to the prescribed treatment regimen and attend follow-up appointments to monitor disease progression and potential side effects 5, 4.
- Lifestyle modifications: The patient should be advised to avoid alcohol consumption, as it may interact with the medication or exacerbate the disease 3.
- Emotional support and self-care: The patient should be provided with emotional support and educated on self-care techniques to manage the disease and its impact on daily life 6, 7.