Lupus Erythematosus

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Lupus Erythematosus

• BarShaina Lamar
• Chem4205
• Dr. Clower
• March 24, 2008

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What is Lupus

• Autoimmune disease that affect various organs
  such as skin, kidney, liver, joints, and blood
• Latin for wolf
• Named in 1851 by the French physician Cazenave

www.susheewa.com
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Types of Lupus

• Discoid
• Systemic
• Drug-induced
• Neonatal

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Who is at risk?

• 1.5- 2 million American are affected
• 90 are women
• More common in African American, Latinos, Asian,
  and Native Americans than in Caucasian

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Symptoms

• Skin butterfly rash across the check, ulcers in
  the mouth, hair loss
• Joint pain , redness, swelling
• Kidney abnormal urinalysis, excessive protein in
  the urine
• Inflammation in the lining of the lungs, heart,
  and / or around the heart

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Symptoms, cont.

• Blood RBC are destroyed by autoantibodies, low
  WBC count, low number of platelets
• Lungs infiltrates
• Nervous system seizures

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Laboratory Test

• Le cell test
• Anti-nuclear test
• Anti-DNA antibody test
• Anti-Sm antibody test
• Serum Complement test

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Treatment for Joints

• Prednisone
• Naprosyn
• Hydroxycholoroquin (Plaquenil)

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Treatment for Kidneys

• Cellcept
• Ranitidine
• Sensipar

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History of Prednisone

• Arthur Nobile
• Introduced 1955
• Used bacteria to oxidize cortisone to prednisone
  and hydrocortisone to prednisolone

www.invent.org
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Mechanism of Action

• Glucocorticoid agonist
• Prodrug
• Crosses cell membrane and binds to 2 types of
  receptors
• Reduces leukocyte, scar tissue, and immune
  response

Prednisone
Prednisolone
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Side effects

• Weight gain
• Problem with vision
• Shortness of breathe
• Withdrawal

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History of CellCept

• Introduced in 1995
• Manufactured by Roche
• Generic name Mycophenolate mofetil
  (oral/injection)
• Category D

www.epocrates.com
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Mechanism of Action

• Prodrug
• Blocks purine nucleotides
• Inhibit type I and II of the enzyme inosine
  monophosphate dehydrogenase
• Suppress T-cells and B-cells

Mycophenolate mofetil
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Mechanism of Action, cont.
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Side effects

• Fever, chills, body aches, flu symptoms
• Easy bruising or bleeding
• Unusual weakness
• Coughing up blood or vomit
• Feeling like you might pass out

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Patients History

• Diagnosed in 1995
• Stroke- 12/21/98 and 1/1/99
• Cystoscopy-kidney stones removed 7/02
• Placement of stint- 7/19/02- 9/3/02
• Steven Johnson Syndrome-2003
• Blood transfusion-7/26/02 and 5/23/04
• Pneumonia- 5/21/04

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Patients History cont.

• Chemotherapy for kidney failure- 8/26/02-1/24/03
• Kidney biopsy- 12/5/05
• Catheter placement 12/7/05
• Dialysis- 12/8/05
• Fistula- 12/12/05
• Seizures

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Patients Med List
 
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References

• www.drugbank.ca
• www.drugreachers.com
• www.drugs.com
• www.gilhealth.com
• www.lupus.org
• Lupus Foundation of America, Inc. Lupus
  Erythematosus A Handbook for Physicians,
  Patients and Their Families. Washington, DC 1986

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Questions ?