Treatment for Autoimmune diseases

Question 1

always use ____ steroids

best choices are?

Answer 1

oral steroids

pred, methylpred lowest effective dose

Question 2

worst side effect for steroids

Answer 2

GI ulcers!

only cushing in the long term

Question 3

other immunosuppressives

Answer 3

- have lag phases
Azithioprine (no cats, liver metabolism)
chlorambucin (ok in cats)
gold salts (injectable, very long lag phase, risk of drug eruptions)
cyclophosphamide (bladder toxicity)

Question 4

immunomodulatory

Answer 4

tetracycline and niacinamide (more benign tx) but can have liver toxicity and seizures

Question 5

adjunctive therapy

Answer 5

• cyclosporine, decreases need for glucocorticoids
  uses p450
• dapsone, risk of drug eruptions, not a first choice

Question 6

essential things

Answer 6

taper if improvement seen
dont go below maintenance dose (25% of induction dose every other day)
need them to come in every 2 weeks and be closely monitored!