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Pharm 1 > RA & lupus > Flashcards

RA & lupus Flashcards

1
Q

RA and lupus erythematous are inflammatory conditions that result in

A

Pain

Limitation of movement

Destruction or erosion of
Joints, muscles, or ligaments

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2
Q

what is the origin of RA and Systemic Lupus Erythematous

A

Autoimmune

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3
Q

is RA and lupus erythematous systemic or local

A

systemic

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4
Q

what is RA

A

A systemic, autoimmune disease that is a Type III hypersensitivity disorder

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5
Q

RA is an inflammatory disease of what

A

synovium

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6
Q

Environmental and genetic factors of RA

A

Genetic link + triggering event
Inappropriate immune

response to a joint injury??

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7
Q

Risk factors for RA (Age,gender, tobacco use?)

A

40-60s
women
YES tobacco users

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8
Q

Patho of RA

A

Autoimmune attack against the synovial tissue

Immune cells are activated
Lymphocytes
Macrophages

Produce rheumatoid factor (RF):
Auto-Antibody against the body’s own antibody– IgG
Formation of immune complexes and activates complement

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9
Q

what is RA:Progressive disease

A

Intensifying inflammatory response
Cartilage is destroyed by osteoclasts
Pannus develops

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10
Q

what does pannus cause

A

bone erosion
bone cysts
fissure development

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11
Q

RA clinical manifestations for EVENTUAL JOINT MANIFESTATIONS

A

Symmetrical

Pain, stiffness, motion limitation

Inflammation: heat, swelling, tenderness

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12
Q

RA clinical manifestations for ADVANCED DISEASE

A

deformity and disability

joint subluxation

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13
Q

RA systemic involvement

A

Fatigue, malaise

Potentially affect any/all body systems (more severe form)

Most common

  • Rheumatoid Nodules
  • Sjögren’s syndrome (next slides)
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14
Q

What are rheumatoid nodules

A

Immune-mediated granulomas

Develop around inflamed joints and in lungs

Subcutaneous, firm

Sometimes painful

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15
Q

Goals of pharmacotherapy for RA (2)

A
  1. Relieve pain and swelling

2. Slow or stop disease progression

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16
Q

Long-term drug therapy for RA

A

REQUIRES PATIENT ADHERENCE

NSAIDS: immediate relief

Glucocorticoids: short term only

Disease-modifying anti-rheumatic drugs:
(DMARDS) slow the disease process

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17
Q

What is systemic lupus erythematous

A

Autoimmune inflammatory disease:

Multiple organ systems
Acute flare-ups
Unpredictable

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18
Q

systemic lupus erythematous is an autoimmune attack against what

A

body’s own DNA

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19
Q

2 major forms of systmeic lupus erythematous

A

discoid

systemic

20
Q

systemic lupus Patho

A

B-lymphocytes are hyperactive and produce autoantibodies

ANA: antinuclear antibody

Activated against DNA

Formation of: Immune complexes

Can impact all major organ systems!

Inflammatory response destroys tissue

21
Q

SLE manifestations (7)

A

Extreme fatigue

Photosensitivity

Butterfly rash

Fever

Weight changes

Unusual hair loss

Edema

22
Q

SLE CNS manifestions

A

HA

dizzy

seizure

stroke

23
Q

SLE lungs manifestations

A

pleuritis

pleural effusions

24
Q

SLE heart manifestations

A

myocarditis

endocarditis

25
Q

SLE Kidneys manifestations

A

nephritis

26
Q

SLE blood vessels manifestations

A

Vasculitis

27
Q

SLE blood manifestations

A

anemia

leukopenia

thrombocytopenia

blood clots

28
Q

SLE joint manifestations

A

Arthritis

29
Q

What is a flare

A

acute exacerbation of symptoms

30
Q

Warning signs of a flare

A

fatigue

pain
H/A

31
Q

What is the prevention of flares

A

recognize warning signs and avoid triggers

Sunlight exposure
Infection
Abruptly stopping a medication
Stress

32
Q

Flares clinical course

A

exacerbations and remissions

33
Q

what is Sjogren Syndrome

A

Autoimmune destruction of any moisture-producing gland

Enlarged glands with decreased functioning

34
Q

DMARDs drug name

A

Methotrexate

hydroxychloroquine

35
Q

class of methotrexate

A

Antineoplastic (folic-acid antimetabolite), antirheumatic

36
Q

MOA of methotrexate

A

immunosuppressive

37
Q

How is methotrexate administered

A

weekly via PO or SQ/IV route

38
Q

S/E of methotrexate

A

GI
Bone marrow suppression
Shortened life expectancy

39
Q

nursing care for Methotrexate

A 
Number of FDA Black Box Warnings: 11
Folic acid supplementation is necessary
Absolutely no alcohol
Absolutely no administration to a pregnant female
Contact HCP if develop:
Signs of infection
40
Q

class of hydroxycholorquine

A

Antimalarial, antirheumatic agent

41
Q

MOA of hydroxychloroquine

A

Unknown, antiinflammatory properties

42
Q

drug effects of hydroxychloroquine

A

Slow progression of RA when used with another DMARD

43
Q

Therapeutic Uses

hydroxychloroquine

A

Used alone or in combination with Methotrexate for early/mild RA

44
Q

Side/Adverse Effects

hydroxychloroquine

A

Rare: Retinopathy

45
Q

similarities bewteen RA and SLE

A

Autoimmune diseases
Systemic inflammation
Multiple body system
Pharmacotherapy

46
Q

Major difference between RA and SLE

A 
RA = focus on joints (sometimes organs)
SLE = multisystem (sometimes joints)

Pharm 1 (28 decks)

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