FMS Week 10 Systemic Lupus Erythematosus Flashcards
Systemic Lupus Erythematosus: Affected Organ Systems
6 Listed
Systemic Lupus Erythematosus: Goals of Therapy
3 Listed
Systemic Lupus Erythematosus: Mild Disease can be treated with?
3 Listed
Systemic Lupus Erythematosus: Severe Disease can be treated with?
2 Listed
Treatment of SLE patients with Prednisone is associated with increased risk of _________
Cardiovascular Events
Steroid-sparing Therapy Challenge
2 Listed
- The onset of therapeutic response for immunosuppressants is slower with prednisone
- Patients often need immediate relief
Steroid-sparing therapy organ involvement
Organ involvement may influence choice
- If a primary symptom is arthritis, methotrexate, hydroxychloroquine, or mycophenolate mofetiil
- For photosensitive rashes, azathioprine, or leflunomide
Steroid-sparing therapy: if the primary symptom is arthritis?
3 Listed
- Methotrexate
- hydroxychloroquine
- mycophenolate mofetil
Steroid-sparing therapy: For photosensitive rashes?
2 Listed
- azathioprine
- leflunomide
Methotrexate can cause __________
Photosensitive Rash
Hydroxychloroquine MOA
MOA in SLE is not known
Hydroxychloroquine Reduces
- Skin inflammation
- mouth sores
- joint pain
Hydroxychloroquine Toxicities
7 Listed
- headache
- dizziness
- hair loss
- nausea
- muscle pain
- rash and itching
- may worsen psoriasis
Hydroxychloroquine Rare but serious toxicities
4 Listed
- Leukopenia (reduction of the number of white cells)
- Thrombocytopenia (low blood platelet count)
- anemia
- retinal damage
Hydroxychloroquine Warning
G6PD deficiency associated with severe anemia
Hydroxychloroquine Irreversible retinal toxicity
Azathioprine MOA
6-thioguanine metabolite exerts cytotoxic and immunosuppressive actions
Azathioprine toxicity
3 listed
- can cause myelotoxicity (bone marrow suppression) and hepatotoxicity
- should run CBC and liver function tests
Azathioprine: CBC
if lymphocyte count is low but the liver function test is normal, then low lymphocyte count is probably not due to a drug toxicity, as low lymphocyte count is often associated with SLE
Lupus Nephritis and end-stage renal disease
at 10-year follow up 20% have end-stage renal disease
Lupus Nephritis: Induction and maintenance therapies
2 Listed
- Mycophenolate mofetil (MMF)
- Cyclophosphamide
Lupus Nephritis: Prednisone and cyclophosphamide
Mycophenolate Mofetil (MMF) and Cyclophosphamide for the treatment of lupus nephritis
2 Listed
Cyclophosphamide toxicities include increased risk of?
3 Listed
- Infection
- Amenorrhea
- ovarian toxicity
MMF AKA
Mycophenolate Mofetil
MMF may be _______ toxic than cyclophosphamide
less
MMF is a _________ inhibitor of ________ and ___________________.
Selective, B and T cell Proliferation
Treatment of Resistant lupus nephritis
3 listed
Eicosanoids
Organ-System Effects of Eicosanoids
6 Listed
Cardiovascular System Actions of Prostaglandins
Cardiovascular System Actions of Leukotrienes
Cardiovascular System Actions of Thromboxanes
Prostoglandins in the kidney
Pulmonary System
Gastrointestinal System
Bone formation and resorption
Glucocorticoid effects in connective tissue, bone, calcium metabolism, metabolic effect
Glucocorticoid Effects on CNS, ophthalmologic effects, immunologic function
