final lecture 2 Flashcards
(25 cards)
____ are leading causes of death in SLE pts
complications of therapies & infection
goals of SLE therapy
ensure long-term survival
induction & maintenance of remission
improve QOL
minimize complications associated w/ treatments
non-drug SLE therapy
rest & exercise, avoid stress, smoking cessation, limit sun exposure, counseling & support services
when to use NSAIDs for SLE
fever, arthritis, skin rash, erositis (manage inflammation & pain)
decrease in renal function may be a side effect of
NSAIDs, rather than lupus nephritis
use ____ in all SLE pts
antimalarials
hydroxychloroquine dose
200-400mg/day
chloroquine dose
250-500mg/day
key monitoring for antimalarials
eye exams
onset of antimalarials
prolonged- may need steroid bridge therapy
when to use corticosteroids
more serious clinical manifestations, SLE symptoms unresponsive to other meds
steroid dose
mild: 10-20mg/day
severe: 1-2mg/kg/day
steroid pulse dosing
IV bolus 500-1000mg X3-6 days methylprednisolone followed by 1-1.5mg/kg/day prednisone
role of steroids in life-threatening disease
severe active nephritis, CNS invlvement, hemolytic disease
pulse dose steroids may be
quicker response & decreased side effects compared to long-term
prophylaxis needed w/ corticosteroid use
osteoporosis
when to use immunosuppresive agents
in combo w/ steroids for lupus nephritis
cyclophophamide is useful for
induction of remission
azathioprine is useful for
mainenance of remission
biologic agents used in SLE
belimumab & rituximb
when to use biologics
in combo w/ other agents to induce remission for refractory lupus
____ should not be placed on belimumab
african americans
meds that can cause SLE
procainamide & hydralazine
SLE chacteristics
15-45yo, females >males, common malar rash, psych symptoms
