Pharm - Lupus Treatment

What is not an environmental trigger for Lupus?

Up to 10% of lupus cases may be drug-induced, which of the following drugs can lead to drug-induced lupus? These drugs should also be avoided in patients with lupus.

Drug-induced lupus usually (DIL) presents with more musculoskeletal symptoms than non-drug induced.

Most patients with lupus will likely progress to having renal involvement as a part of the disease.

What is key to the treatment of Renal Lupus?

A goal of treatment for Lupus is to limit the use of corticosteroids to less than 15 mg per day.

What patient education is NOT correct for a patient with Lupus?

What medication is recommended for all SLE patients, regardless of severity?

What is the maximum dose for Hydroxychloroquine?

What can occur for patients that are using Hydroxychloroquine for SLE?

A patient with SLE that is already taking Hydroxychloroquine is experiencing a mild flare of symptoms. What should you recommend for this patient?

What can patient with SLE use for more serious or unresponsive clinical manifestations of lupus such as Lupus nephritis, CNS disease, Pneumonitis, Vasculitis, and/or Thrombocytopenia?

Corticosteroids for SLE

Why is Imuran (Azathioprine) used more commonly than Methotrexate in achieving symptom control for patient's on Hydroxychloroquine?

What medication suppresses cell- mediated immune responses and antibody formation and is effective in renal and non-renal SLE as alternative for induction of remission in both SLE and renal SLE?

What pharmaceutical therapy is appropriate for treatment of lupus dermatitis?

Intralesional administration of corticosteriods can be used for q4-6 weeks for discoid lupus

What SLE Nephritis drug is the standard of care for focal and diffuse lupus nephritis, but can cause hemorrhagic cystitis?

What Lupus nephritis drug is the standard of care for focal and diffuse lupus nephritis and can be also used for severe organ threatening or life threatening SLE as well as for “rescue” therapy in patients not responding to other agents?

What drug regime is recommended for Lupus nephritis Class I and II?

Class III (focal) and IV (diffuse) SLE respond to which agents?

What is the Class V SLE induction treatment?

What therapies can be used as maintenance therapy for SLE nephritis?

What additional therapy can be used for patients experiencing either musculoskeletal or cutaneous disease that is not being controlled by their Hydroxychloroquine and steroids?

Patients with lupus should avoid Alfalfa sprouts, garlic supplements and echinacea.

What is the maintenance dose for Hydroxychloroquine?

80% of SLE patients will require low dose steroids as maintenance therapy

A patient is on Hydroxychloroquine and steroids for SLE. What medication can be added to this combination to help lower the daily dose for steroids (steroid sparing)? This option is safe in pregnancy.

A patient is on Hydroxychloroquine and steroids for SLE. What medication can be added to this combination to help with symptoms control? This option is NOT safe in pregnancy.

What medication do patients with Lupus nephritis need to decrease proteinuria?

What medication is used in Lupus nephritis to achieve LDL goal of <100? This medication is indicated is LDL go above 100.

What medication is an alternative for patients refractory to other treatments for Lupus nephritis? This medication may also be more effective in African Americans.

ASA 81mg daily for patients with antiphospholipid antibodies (APLA) and needs to be considered for patients with multiple fetal loss.

Oral contraceptives have not been shown to increase SLE flares

What medication was recently approved and used in treating active autoantibody-positive SLE in patients on standard therapy?

What medication can be used for acute exacerbations as an add on therapy and works by increasing cortisol levels?

What medication can cause hemorrhagic cystitis when used as the induction agent for lupus nephritis?