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PHRM 825 > PHRM 825: SLE > Flashcards

PHRM 825: SLE Flashcards

1
Q

What is systemic lupus erythematosus?

A
  • Chronic autoimmune disease
  • Severity varies with periods of relapse and remitting symptoms
  • No cure
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2
Q

Pathophysiology of lupus

A
  • Largely unknown
  • Sex chromosome X linked theory
  • Polymorphisms in gene make up
  • Triggers in daily life
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3
Q

What results in the damaged caused by lupus?

A

Inflammation

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4
Q

What environmental triggers can cause lupus?

A
  • Cigarette smoke
  • Petroleum adn solvents
  • Psychological stress
  • Silica dust, solvents, nail polish
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5
Q

What are the cutaneous manifestations of SLE?

A
  • Butterfly rash

- Red, raised, scaly nonscarring rash on sun-exposed areas

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6
Q

What is the most deadly aspect of SLE and how many patients with SLE are affected by it?

A 
Lupus nephritis (LN)
40-60%
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7
Q

What is the MOA of Lupus nephritis?

A

Damage and inflammation of the glomerulus

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8
Q

What are the s/sx of lupus nephritis?

A
  • Hematuria
  • Proteinuria causing foamy urine
  • Increased SCr
  • HTN
  • Edema
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9
Q

What is the MOA of lupus cerebritis?

A
  • Decreased blood flow to the brain caused by vasculitis
  • Clots due to anti-phospholipid syndrome
  • Increase in cytokines which can interfere with neuron function
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10
Q

What are s/sx of lupus cerebritis?

A
  • Anxiety
  • Depression
  • Psychosis
  • Seizures
  • Cognitive and mood abnormalities
  • Migraines
  • Neuropathy
  • Stroke
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11
Q

What drugs can cause drug induced lupus (DIL)?

A
  • Procainamide
  • Hydralazine
  • Isoniazid
  • Chlorpromazine
  • Methyldopa
  • Minocycline
  • Quinidine
  • TNF-alpha inhibitors
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12
Q

What is the mnemonic for the ACR diagnostic criteria and how many of these symptoms have to be present to be able to diagnose SLE?

A

DOPAMINE RASH

Must include 4 or more symptoms

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13
Q

What are 5 non-pharmacologic treatment options for SLE?

A
  • Sun protection
  • Nutrition
  • Exercise
  • Immunizations (NO LIVE VACCINES)
  • Smoking cessation
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14
Q

What 5 medication classes can be used to treat SLE?

A
  • NSAIDs
  • Antimalarial agents
  • Corticosteroids
  • Cytotoxic agents
  • Biologics
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15
Q

What is the MOA of antimalarials?

A
  • Not fully understood
  • Inhibits movement of neutrophils and eosinophils
  • Impairs complement-dependent antigen-antibody reactions
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16
Q

What are the baseline monitoring parameters for NSAIDs?

A
  • SCr
  • Urinalysis
  • CBC
  • LFTs
  • BP
17
Q

What are the baseline monitoring parameters for Antimalarials?

A
  • Ophthalmologic
  • SCr
  • CBC
  • LFTs
18
Q

What is the MOA of topical corticosteroids?

A
  • Anti-inflammatory

- Suppress immune response

19
Q

Where are high potency topical corticosteroids used?

A
  • Scalp
  • Soles
  • Palms
20
Q

Where are mid-potency topical corticosteroids used?

A
  • Trunk

- Extremitites

21
Q

Where are low-potency topical corticosteroids used?

A

Face

22
Q

What topical corticosteroid delivery systems are used for the body and scalp?

A
  • Body: Creams and ointments

- Scalp: foams and solutions

23
Q

What is the MOA of systemic corticosteroids?

A
  • Anti-inflammatory

- Suppress immune response

24
Q

What are the baseline monitoring parameters for systemic corticosteroids?

A
  • BP
  • Bone mineral density
  • BMP
  • FLP
25
Q

What is the MOA of cytotoxic agents?

A

Suppression of immune function

26
Q

What medications are considered cytotoxic agents?

A
  • Cyclophosphamide
  • Azathioprine
  • Mycophenolate mofetil
27
Q

What is the MOA of biologic agents?

A

-B-cell reduction

28
Q

What 2 agents are biologics?

A
  • Belimumab

- Rituximab

29
Q

What is the MOA of methotrexate?

A

Inhibits folic acid reductase (requires folic acid administration to prevent toxicities)

30
Q

Why should you avoid pregnancy in active SLE?

A
  • Miscarriage
  • Preeclampsia
  • Pre-term labor
  • Fetal growth retardation
  • Maternal mortality
  • Increased risk of exacerbation
31
Q

What 3 SLE medications are contraindicated in pregnancy

A
  • Cyclophosphamide
  • Mycophenolate mofetil
  • Methotrexate
32
Q

What medication is the drug of choice for SLE in a pregnant patient?

A

Hydroxychloroquine

33
Q

What medications are used to treat mild SLE?

A

NSAID +/- antimalarial

34
Q

What medications are used to treat moderate SLE?

A

NSAID + antimalarial +/- maintenance systemic steroids

35
Q

What medications are used to treat severe SLE? (including lupus nephritis and CNS lupus)

A

NSAID + antimalarial +/- maintenance systemic steroids +/- cytotoxic agent

36
Q

What medications are used to treat refractory SLE?

A

NSAID + antimalarial + maintenance systemic steroids +/- cytotoxic agent +/- biologic agent

PHRM 825 (36 decks)

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