Answer 71
Thalidomide is used in the treatment of
False a. HIV-associated peripheral neuropathy
False b. hyperemesis gravidarum
True c. erythema nodosum leprosum
True d. Behcet's disease
True e. HIV-associated mouth ulcers
F F T T T
This drug was used in the 1960's to treat hyperemesis gravidarum and is notorious for its association with phocomelia. It should never be used in pregnancy. It is an anti-inflammatory, immunomodulant drug which acts by interfering with phagocyte migration and TNF-alpha secretion. It has no direct effect on lymphocytes and does not inhibit HIV replication. It is beneficial in HIV-associated mouth ulcers and may have a role in HIV-associated cachexia. It is also beneficial in mucocutaneous ulceration not associated with HIV. Other conditions reported to respond to thalidomide include: discoid lupus erythematosus, erythema multiforme, ulcerative colitis, rheumatoid arthritis and chronic graft-versus-host disease. The incidence of side effects is high, mainly peripheral neuropathy. It has no product licence in the UK. For these reasons its use should be restricted: it should probably only be used when other appropriate drugs have been tried but have failed.
