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Therapeutics 1 Kappa Epsilon Version > SLE > Flashcards

SLE Flashcards

1
Q

Etiology of SLE

A
  • unknown..
  • Hormonal Factors: Estrogen and Androgens
  • Genetic factors: Polymorphism
  • Environmental Triggers
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2
Q

What are some Environmental triggers for SLE

A

Diet - Alfalfa Sprouts; Saturated Fats
Hydrazines (aka aromatic amine exposure) - like hair dyes and tobacco smoke
UV light - Natural or Artificial

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3
Q 
Pathophysiology of SLE:
\_\_\_\_\_\_\_\_\_\_\_\_\_ Abnormalities
and
\_\_\_\_\_\_\_\_\_\_\_ shift
overall will lead to \_\_\_\_\_\_\_\_\_\_\_\_\_
A

immunological; T Helper Cell; increase in auto-antibodies

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4
Q

Presentation of SLE:

same for every patient or can vary a lot?

A

varies hella much - even within a patient (a flare up from before may not cause a flare anymore…)

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5
Q

Clinical Features seen in SLE:

Constitutional Sx

A

fatigue/fever/weight loss

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6
Q

Clinical Features seen in SLE:

Cutaneous

A

MALAR RASH (aka butterfly rash); Photosensitivity; oral ulcers; alopecia; Discoid Rash; Raynaud’s Phenomenon

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7
Q

Clinical Features seen in SLE:

Renal

A

Lupus Nephritis (v severe); Hematuria/Proteinuria

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8
Q

Clinical Features seen in SLE:

GI

A

N/V; Anorexia; Abdominal pain

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9
Q

Clinical Features seen in SLE:

Neurologic

A

Psychosis, seizures, depression, anxiety

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10
Q

What is Raynaud’s Phenomenon?

A

vessels in extremities contract - less blood flow - discoloration seen in tips of fingers

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11
Q

Clinical Features seen in SLE:

Cardiovascular

A

Pericarditis/ CAD / HTN / Valvular disease

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12
Q

Clinical Features seen in SLE:

Pulmonary

A

Coughing/Dyspnea/Pelurisy

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13
Q

Clinical Features seen in SLE:

Hematologic

A

Hemolytic anemia; Leukopenia; Thrombocytopenia; ANTIPHOSPHOLIPID Abs

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14
Q

Clinical Features seen in SLE:

Immunologic

A

Autoantibody Production

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15
Q

ACR Diagnostic Criteria for SLE - what is their mnemonic for it?

A

DOPAMINE RASH

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16
Q

What does DOPAMINE RASH stand for

A 
its how to diagnose SLE - need 4/11 
D - discoid rash
O - Oral ulcers
P - Photosensitivity
A - Arthritis
M - Malar rash
I - Immunologic Involvement
NE - neurologic involvement

R - Renal involvement
A - Antinuclear Ab +
S - Serositis
H - Hematologic Involvement

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17
Q

ACR uses DOPAMINE RASH for SLE Diagnosis - is SLE related to dopamine?

A

nah

18
Q

ACR guidelines - how many symptoms are needed to be diagnosed with SLE

A

4 (out of the possible 11)

19
Q

What is the SLICC Criteria to be diagnosed with SLE

A

need 4/17 criteria
- at least 1 immunologic crterion
and
- at least 1 clinical criterion

20
Q

If don’t use 4/17 criteria for SLICC - you can diagnose with this criteria - Biopsy proven ________ –> Systemic Lupus w/ ________

A

Nephritis; + ANA and + Anti-dsDNA

21
Q

Non-Pharm treatment options for SLE:

A
  • Limit sun exposure
  • Nutrition (balanced diet during remissions; may need more calories during flares)
  • Immunizations (NO LIVE VACCINES in immunocompromised/caution during flares)
  • Smoking Cessation (smoking can increase flares)
  • Exercise (exercise can control flares)
22
Q

5 main groups of Pharmacological treatment for SLE

A
  • NSAIDs
  • Antimalarial Agents
  • Corticosteroids
  • Cytotoxic Agents
  • Biologic Agents
23
Q

when using NSAIDs in SLE patients - what ADR is more of a concern in SLE pts over the normal population

A

Greater incidence of HEPATOTOXICITY can be seen in SLE pts when taking NSAIDs

24
Q

What are the antimalarial agents used in SLE

A

hydroxychloroquine and Chloroquine

25
Q

when to use the antimalarial agents in a SLE pt

A

if NSAIDs did not work/ there are cutaneous symptoms

26
Q

what is the first line agent to use in SLE pts and when to use it?

A

NSAIDs! use for mild arthritis/fever/muscoskeletal pain

27
Q

Antimalarial ADRs

A
  • RETINAL TOXICITY
  • Dermatologic
  • CNS
  • GI
28
Q

Biggest thing to monitor for Antimalarial Agents

A

Ophthalmologic

29
Q

Corticosteroids - Topical Agents - are ______ line therapy for cutaneous symptoms

A

second (may be used adjunctively to NSAIDs or anti-malarials)

30
Q

which medication option can lead to Telangiecatasias

A

topical corticosteroids can lead to this (its aka “spider veins”)

31
Q

which agent do you have to check bone mineral density - due to the risk of osteoporosis

A

SYSTEMIC corticosteroids

32
Q

what are cytotoxic agents that can be used for SLE

A
  • cyclophosphamide
  • Azathioprine
  • Mycophenolate mofetil
33
Q

which agent should decrease its dose if the pt is also taking allopurinol or Febuxostat

A

Azathioprine

34
Q

MOA of Azathioprine

A

inhibits purine synthesis and DNA replication

35
Q

MOA of Mycophenolate

A

inhibits proliferation and differentiation of lymphocytes

36
Q

which drug needs to test for TPMT enzyme before use?

A

Azathioprine (that enzyme metabolizes the drug - know levels of TPMT - makes dosing more effective)

37
Q

which cytotoxic drug do you need to test/do urinalysis monitoring?

A

Cyclophosphamide (bc of bladder cancer risk)

38
Q

Which cytotoxic drug do you have to chest x-rays for?

A

Mycophenolate (bc of pulmonary risk)

39
Q

Antiphospholipid syndrome - importance to SLE pts?

A

if they have this syndrome they are at a greater risk for clotting

40
Q

which agent used for SLE - is the drug of choice for pregnant women

A

Hydroxychloroquine

41
Q

caution of SLE pt on estrogen containing contraceptives?

A

if pt with SLE has antiphospholipid syndrome AND on estrogen containing contraceptives (BIG RISK FOR CLOTTING!)

42
Q

Most Common Drugs that cause Drug Induced Lupus

A
  • Procainamide
  • Hydralazine
  • Chlorpromazine

Therapeutics 1 Kappa Epsilon Version (17 decks)

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