Autoimmune Dx - Systemic Lupus Erythematosus (SLE)

Question 1

What’s the most common SE of SLE?

Answer 1

Butterfly rash (xteristic red, flat facial rash over bridge of nose and cheeks)

Question 2

What’s the most common manifestations of SLE?

Answer 2

Arthritis and cutaneous manifestations

Question 3

What manifestations contribute largely to morbidity and mortality?

Answer 3

Renal

Hematologic

Neurologic

Question 4

What develops in over 50% of pts with SLE?

Answer 4

Lupus nephritis

Question 5

List primary agents ass with drug-induced lupus?

Answer 5

Procainamide

Hydralazine (alone and in BiDil)

Isoniazid

Methyldopa

Propylthiouracil

Methimazole

Terbinafine

Anti-TNF agents

Question 6

List non-pharmacologic therapy for lupus

Answer 6

Rest

Proper exercise

Smoking cessation (if applicable)

Sunscreen or avoiding sun (photosensitivity)

Question 7

What’s the goal of SLE therapy?

Answer 7

Suppress immune system to avoid flare and keep pt in remission

Question 8

What’s the tx method for SLE?

Answer 8

Combo of drugs to minimize chronic exposure to corticosteroids

Question 9

List antimalarial agents used in lupus

Answer 9

Hydroxychloroquine

Chloroquine

Question 10

MOA of antimalarial agents

Answer 10

Impair complement-dependent antigen-antibody rxn

Question 11

Which antimalarial is preferred (safer)?

Answer 11

Hydroxychloroquine

Question 12

How long does it take to see maximal effect of hydroxychloroquine in SLE?

Answer 12

6 months

Question 13

What’s hydroxychloroquine used for?

Answer 13

Mild dx; chronic (not acute) therapy

Effective for cutaneous sx and Arthralgias

Question 14

Which corticosteroids is used as an agent in lupus?

Answer 14

Prednisone OR Methylprednisolone IV

Question 15

Which cytotoxic agents are used in severe dx of lupus?

Answer 15

Cyclophosphamide

Azathioprine

Mycophenolate mofetil (CellCept)

Cyclosporine

Question 16

What’s the brand name of Mycophenolate mofetil?

Answer 16

CellCept

Question 17

What’s the SE of cyclophosphamide (cytotoxic agent used in severe dx of lupus)?

Answer 17

Hemorrhagic cystitis

Question 18

How do u deal with Hemorrhagic cystitis that results from cyclophosphamide?

Answer 18

Mesna therapy + hydration

Question 19

Howz cyclophosphamide used in lupus?

Answer 19

For flares as induction therapy

NOT for chronic therapy…very toxic

Question 20

SE of Mycophenolate (CellCept) use?

Answer 20

Diarrhea

GI upset

Vomiting

Hypo- and hypertension?

Edema

Tachycardia

Pain

Hyperglycemia

Hypo and hyperkalemia

Hypomagnesemia; calcemia

Hypercholesterolemia

Tremor

Acne

Infections

Question 21

What’s the brand name for cyclosporine?

Answer 21

Neoral/ Sandimmune

Question 22

SE of cyclosporine (neoral/ Sandimmune)?

Answer 22

Hypertension

Nephropathy

Question 23

MOA of IgG1-lambda monoclonal antibody?

Answer 23

Prevents the survival of B lymphocytes by blocking the binding of soluble human B lymphocyte stimulator protein (BLyS) to receptors on B lymphocytes

Question 24

List agents that are IgG1-lambda monoclonal antibody

Answer 24

Belimumab (Benlysta)

Question 25

What’s the brand name of Belimumab?

Answer 25

Benlysta

Question 26

What’s the hallmark of SLE?

Answer 26

Development of auto-antibodies by B cells to cellular components that leads to chronic inflammation and tissue damage