Sulfasalazine baseline monitoring — GPhC CRA MCQ

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ModerateAdverse Drug ReactionsSulfasalazine baseline monitoringGPhC CRA

A 48-year-old woman presents with a new prescription for sulfasalazine 500 mg once daily, increasing to 1 g twice daily over four weeks, for rheumatoid arthritis. What is the most important baseline test before starting treatment?

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Correct answer: E — Full blood count and liver function tests

Before starting sulfasalazine, baseline full blood count and liver function tests should be performed. Sulfasalazine can cause blood dyscrasias (including leucopenia and agranulocytosis) and hepatotoxicity. The BNF recommends FBC and LFTs at baseline, monthly for the first three months, then three-monthly. Patients should also be counselled to report signs of infection, bruising, or sore throat.

Reference: BNF; NICE NG100 Rheumatoid Arthritis