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54
How do I treat lupus erythematosus and minimize the associated drug toxicity?
● The treatment is determined by the disease activity and by organ involvement.
● In the absence of major-organ involvement, the cornerstone drug hydroxychloroquine is supplemented as-needed with an NSAID such as naproxen and with prednisolone in low to moderate doses. Mycophenolate mofetil, azathioprine, and methotrexate are reserved for refractory cases.
● In lupus with major-organ (kidney, CNS) involvement, these treatment options extend onto low-dose cyclophosphamide and belimumab, an antibody against the B-lymphocyte stimulator. The induction therapy is more intensive than the subsequent maintenance therapy.
● Prevention and monitoring of drug toxicities are similar to those recommended for rheumatoid arthritis. Give vitamin D to offset the effects of glucocorticoids and the recommended sunlight avoidance.
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● In the absence of major-organ involvement, the cornerstone drug hydroxychloroquine is supplemented as-needed with an NSAID such as naproxen and with prednisolone in low to moderate doses. Mycophenolate mofetil, azathioprine, and methotrexate are reserved for refractory cases.
● In lupus with major-organ (kidney, CNS) involvement, these treatment options extend onto low-dose cyclophosphamide and belimumab, an antibody against the B-lymphocyte stimulator. The induction therapy is more intensive than the subsequent maintenance therapy.
● Prevention and monitoring of drug toxicities are similar to those recommended for rheumatoid arthritis. Give vitamin D to offset the effects of glucocorticoids and the recommended sunlight avoidance.
≣
Flashcard info:
Author: LWojnowski
Main topic: Medicine
Topic: Pharmacology
School / Univ.: University Clinical Center
City: Mainz
Published: 24.05.2013