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31 Cards in this Set
- Front
- Back
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what are the hallmarks of SLE
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autoantibodies to nuclear components
butterfly rash |
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what is the pathophysiology of SLE
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apoptotic cell releases cellular contents
APC takes up the content APC presents it to T lymphocyte T lymphocyte stimulates auto reactive B cell B cell produces autoantibodies towards our self immune complex formation (attracts inflammatory cells such as neutrophils) tissue injury and damage (neutrophils release enzymes) |
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what are some of the affected systems in SLE
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mucoskeletal
CNS (seizures) renal (lupus nephritis) cardiovascular (endocarditis/myocarditis) pulmonary GI |
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what are the 11 criterion of SLE
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malar rash (butterfly rash)
discoid rash photosensitivity arthritis renal disorder serositis (pleuritis) immunologic disorder antinuclear hematologic disorder neurologic disorder |
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if a pt has how many of the criterion do they get diagnosed as having Lupus
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4 of 11
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what are the Rx options for treating lupus
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NSAID - mild
antimalarial corticosteroids - severe cytotoxic agents - severe |
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what type of lupus do Antimalarials treat
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discoid lupus and SLE
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what is the MOA of antimalarials
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-interfere with T lymphocyte activation
-mgmt of arthralgia, fatigue, fever -for long term management |
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what are the SE of antimalarials
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reversible ocular toxicities
-pt should get opthalmologic evaluation at baseline |
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what are examples of antimalarials
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hydroxychloroquine
chloroquine |
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what is the MOA of corticosteroids
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suppress clinical expression of the disease (decrease mRNA)
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what drugs are the cytotoxic agents
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cyclophosphamide
azathioprine mycophenolate mofetil |
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what type of lupus does cyclophosphamide treat
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lupus nephritis
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what are the SE of cyclophosphamide
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hematopoeisis
oppurtunistic infections bladder complications sterility teratogenesis |
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what should you monitor when a pt is on cyclophosphamde
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UOP
WBC |
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what is a pt counseling tip for cyclophosphamide
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make sure pt is hydrated
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what is the MOA of cyclophosphamide
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potent immunosuppressive activity
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when is azathioprine used
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to allow for a decrease in steroid dose
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what is the MOA of azathioprine
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may prevent renal flares after induction with cyclophosphamide
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what are teh SE of azathioprine
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myelosuppression
cancer hepatotoxicity ovarian flare |
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what must you monitor with azathioprine
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CBC
AST |
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when is mycophenolate mofetil used
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severe renal and nonrenal lupus refractory to cytotoxic agents
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what is the MOA of mycophenolate mofetil
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inhibits proliferative response of B and T lymphocytes therefore they don't react to self
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what are the SE of mycophenolate mofetil
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leukopenia
htn hepatitis |
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what are the properites of Pregnant women with SLE
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exacerbation of disease
antiphospholipid antibodies which can cause spontaneous abortion |
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what are pts with antiphospholipid syndrome on
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anticoagulates b/c they clot more often
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what are the special populations of SLE pts
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pregnant
antiphospholipid syndrome |
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what kind of antibodies do hyperactive B cells produce
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antiphospholipid antibodies
antinuclear antibodies |
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what drugs can induce lupus
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procainamide
hydralazine |
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what are the criteria in order to be diagnosed with Drug induced lupus
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exposure to suspected drug
no prior history of Lupus prior to drug exposure atleast one clinical feature of SLE improvement of symptoms following drug discontinuation |
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how do you treat Drug induced lupus
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d/c offending agent
NSAID if musculoskeletal manifestations |
