Beruflich Dokumente
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Furqan Khan RN BSN CWCN NURS 504 Advanced Pharmacology Liberty University
Edmunds, M. W., & Mayhew, M. S. (2009). Pharmacology for the primary care provider. St. Louis, MO: Saunders.
Petri, M., Lazaro, D. (2009). Systemic Lupus Erythematosus: Physicians Information & Education Resource .
The etiology of SLE is currently unknown, but there are environmental and genetic factors involved Environmental Factors: Ultraviolet light ( UVB ), Alfalfa sprouts, chemicals ( hydrazines) ? Drugs (Resprim = Trimethoprim + sulphamethoxazole), Infections (parvovirus, CMV, HCV ), Smoking B cell activation results in increased autoantibody (mainly IgG) production to a variety (up to 2000) of antigens (nuclear, cytoplasmic and plasma membrane), e.g. ANA, anti-dsDNA. Development of and failure to remove immune complexes from the circulation leads to deposition of complexes in the tissue, causing vasculitis and disease (e.g. glomerulonephritis). Immune complexes also from in situ, e.g. kidney glomerular basement membrane. There is impaired T cell regulation of the immune response.
Petri, M., Lazaro, D. (2009). Systemic Lupus Erythematosus: Physicians Information & Education Resource . Retrieved from http://online.statref.com
Petri, M., Lazaro, D. (2009). Systemic Lupus Erythematosus: Physicians Information & Education Resource . Retrieved from http://online.statref.com
PHOTOSENSITIV E ERYTHEMA
DISCOID LUPUS
Images : dermatlas.org
Er ythematosus Test
The most common anemia in SLE is from chronic disease. Hemolytic anemia will usually have a positive direct Coombs' test, for either IgG or complement, or both. Both Leukopenia and Lymphopenia are found in SLE. Thrombocytopenia can be due to SLE or to Antiphospholipid antibodies Although the ESR is commonly elevated, it is not specific for SLE An elevated Creatinine may be a clue to renal lupus. Mild elevations in liver function tests occur in 30% SLE Myositis presents with proximal muscle weakness. Creatine phosphokinase is usually elevated Glomerulonephritis usually presents with Proteinuria, with or without Hematuria. Erythrocytes or granular casts can be seen Anti-DNA or anti-Sm are specific for SLE. Low C3 and low C4 are common in SLE, but not specific. A negative ANA argues against SLE. Anti-RNP, anti-Ro/SSA, anti-La/SSB, and Antiphospholipid antibodies may be found, but they are not specific for SLE Indicated in patients with laboratory findings suggestive of lupus nephritis
Serologies
Renal biopsy
http://online.statref.com
Petri, M., Lazaro, D. (2009). Systemic Lupus Erythematosus: Physicians Information & Education Resource . Retrieved from
Petri, M., Lazaro, D. (2009). Systemic Lupus Erythematosus: Physicians Information & Education Resource . Retrieved from http://online.statref.com
NON STEROIDAL ANTI-INFLAMMATORY DRUGS Use to control mild to moderate pain, fever, and various inflammatory conditions, such as rheumatoid arthritis and osteoarthritis. NSAIDS have analgesic, antipyretic, and antiinflammatory properties. Analgesic and anti-inflammatory effects are due to inhibition of prostaglandin synthesis. Antipyretic action is due to vasodilation and inhibition of prostaglandin synthesis in the CNS
Turkoski, B. B., Lance, B. R., & Tomsik, E. A. (2009). Drug information handbook. Hudson, OH: Lexi-Comp.
NON STEROIDAL ANTI-INFLAMMATORY DRUGS Use cautiously in patients with a history of bleeding disorders, GI bleeding, and severe hepatic, renal, or cardiovascular disease. Safe use in pregnancy is not established and, in general, should be avoided during the second half of pregnancy. NSAIDs prolong bleeding time and potentiate the effect of warfarin, thrombolytic agents, some cephalosporins, and anti-platelet agents. NSAIDs may also decrease response to diuretics or antihypertensive therapy.
Turkoski, B. B., Lance, B. R., & Tomsik, E. A. (2009). Drug information handbook. Hudson, OH: Lexi-Comp.
Turkoski, B. B., Lance, B. R., & Tomsik, E. A. (2009). Drug information handbook. Hudson, OH: Lexi-Comp.
Turkoski, B. B., Lance, B. R., & Tomsik, E. A. (2009). Drug information handbook. Hudson, OH: Lexi-Comp.
Turkoski, B. B., Lance, B. R., & Tomsik, E. A. (2009). Drug information handbook. Hudson, OH: Lexi-Comp.
Corticosteroids, especially in large doses, increase susceptibility to and mask symptoms of infection Infections with any pathogen, including viral, bacterial, fungal, protozoan, or helminthic infections in any organ system, may be associated with corticosteroids alone or in combination with other immunosuppressive agents Steroid withdrawal syndrome consisting of lethargy, fever, myalgia can develop following abrupt discontinuance.
Petri, M., Lazaro, D. (2009). Systemic Lupus Erythematosus: Physicians Information & Education Resource . Retrieved from http://online.statref.com
Petri, M., Lazaro, D. (2009). Systemic Lupus Erythematosus :Physicians Information & Education Resource . Retrieved from http://online.statref.com
Hydroxychloroquine is used as an adjunct to corticosteroid therapy in the treatment of discoid lupus erythematosus & systemic lupus erythematosus. Hydroxychloroquine therapy may lead to the regression of skin lesions of discoid or systemic lupus erythematosus and may also have a beneficial effect in patients with systemic lupus erythematosus in whom arthritis is a prominent feature
Moser, R. (2001). Primary Care for Physician Assistants: Clinical Practice Guidelines. New York . McGraw- Hill Medical Publishing.
The usual initial adult dosage of hydroxychloroquine for the treatment of lupus erythematosus is 400 mg once or twice daily for several weeks or months depending on the response of the patient. For prolonged maintenance therapy, 200-400 mg of daily may be adequate. The exact mechanism of anti-malarial action of the drug in the treatment of rheumatoid arthritis and lupus erythematosus have not been determined.
Moser, R. (2001). Primary Care for Physician Assistants: Clinical Practice Guidelines. New York . McGraw- Hill Medical Publishing.
Ophthalmologic examinations should be performed prior to initiation of hydroxychloroquine therapy and periodically (every 3 months) during therapy whenever long-term use of the drug is contemplated. Hydroxychloroquine should be discontinued immediately, if there is any indication of abnormalities in visual acuity or visual field May exacerbate psoriasis and precipitate a severe attack in patients with the disease. Use in psoriasis patients only if potential benefits outweigh risks.
Moser, R. (2001). Primary Care for Physician Assistants: Clinical Practice Guidelines. New York . McGraw- Hill Medical Publishing.
May concentrate in the liver; use with caution in patients with hepatic disease or alcoholism and in patients receiving other hepatotoxic drugs. Hydroxychloroquine and its metabolites are slowly excreted by the kidneys. Hydroxychloroquine may exacerbate porphyria in patients with the condition, drug should not be used in patients with porphyria unless potential benefits outweigh risks.
Moser, R. (2001). Primary Care for Physician Assistants: Clinical Practice Guidelines. New York . McGraw- Hill Medical Publishing.
Petri, M., Lazaro, D. (2009). Systemic Lupus Erythematosus: Physicians Information Education Resource . Retrieved from http://online.statref.com
Petri, M., Lazaro, D. (2009). Systemic Lupus Erythematosus: Physicians Information Education Resource . Retrieved from http://online.statref.com
Petri, M., Lazaro, D. (2009). Systemic Lupus Erythematosus: Physicians Information Education Resource . Retrieved from http://online.statref.com
Petri, M., Lazaro, D. (2009). Systemic Lupus Erythematosus: Physicians Information Education Resource . Retrieved from http://online.statref.com
References
Edmunds, M. W., & Mayhew, M. S. (2009). Pharmacology for the primary care provider. St. Louis, MO: Saunders. Moser, R. (2001). Primary Care for Physician Assistants: Clinical Practice Guidelines. Newyork . McGraw- Hill Medical Publishing. Petri, M., Lazaro, D. (2009). Systemic Lupus Erythematosus: Physicians Information & Education Resource . Retrieved from http://online.statref.com Turkoski, B. B., Lance, B. R., & Tomsik, E. A. (2009). Drug information handbook. Hudson, OH: Lexi-Comp.