TY  - CHAP
M1  - Book, Section
TI  - Systemic Lupus Erythematosus
A1  - Resman-Targoff, Beth H.
A2  - DiPiro, Joseph T.
A2  - Talbert, Robert L.
A2  - Yee, Gary C.
A2  - Matzke, Gary R.
A2  - Wells, Barbara G.
A2  - Posey, L. Michael
PY  - 2017
T2  - Pharmacotherapy: A Pathophysiologic Approach, 10e
AB  - Patient  Care  Process  for  the  Management  of  Systemic  Lupus  ErythematosusCollectPatient  characteristics  (e.g.,  age,  race,  sex,  pregnancy  status)Patient  history  (past  medical,  pregnancies  and  outcomes,  symptoms,  family,  social—dietary  habits,  alcohol  and  tobacco  use)Current  medications  and  prior  lupus  medication  useImmunization  historyObjective  data  (see  Clinical  Presentation  and  Table  87-1)Blood  pressure  (BP),  heart  rate,  height,  weight,  and  BMI;  other  physical  exam  findingsLabs  (metabolic  panel,  Scr,  BUN,  urinalysis,  CBC,  ANA,  antiphospholipid  antibodies,  direct  Coomb's  test,  other  lupus-associated  antibodies,  complement,  inflammatory  markers  (ESR,  CRP)Other  diagnostic  tests  when  indicated  (e.g.,  ECG,  CXR,  skin  or  kidney  biopsy)AssessPresence  of  cutaneous,  renal,  neurologic,  hematologic,  cardiac,  or  pleural  manifestations  of  lupusEvidence  of  antiphospholipid  syndrome  (thromboembolic  events,  miscarriages)Current  medications  that  could  be  associated  with  drug-induced  lupusAppropriateness  and  effectiveness  of  current  lupus  regimen  (see  Figures  87-2  and  87-3)Psychological  effects  of  lupusPlan*Goals  of  treatmentTailored  lifestyle  modifications  (e.g.,  diet,  exercise,  weight  management,  protection  from  sun,  smoking  cessation,  keeping  warm  if  Raynaud  phenomenon  occurs)Drug  therapy  regimen  including  specific  medications  based  on  disease  manifestations,  dose,  route,  frequency,  and  duration;  specify  the  continuation  and  discontinuation  of  existing  therapies  (see  Figures  87-2  and  87-3  and  Tables  87-2  and  87-3)Monitoring  parameters  including  efficacy  (e.g.,  skin  manifestations,  cardiovascular  events,  thromboembolic  events,  miscarriages,  kidney  health,  neurologic  events),  safety  (medication-specific  adverse  effects),  and  timeframePatient  education  (e.g.,  purpose  of  treatment,  dietary  and  lifestyle  modifications,  drug  therapy,  pregnancy  considerations,  osteoporosis  prevention  if  taking  corticosteroids)Self-monitoring  of  skin  and  BP—where  and  how  to  record  resultsImmunizations  as  needed;  consider  timing  of  live  vaccines  with  respect  to  immunosuppressive  drug  useReferrals  to  other  providers  when  appropriate  (e.g.,  physician,  dietician)Implement*Provide  patient  education  regarding  all  elements  of  treatment  planUse  motivational  interviewing  and  coaching  strategies  to  maximize  adherenceSchedule  follow-up  based  on  severity  of  symptoms  and  stabilityFollow-up:  Monitor  and  EvaluateDetermine  goal  attainment  based  on  disease  manifestationsPresence  of  adverse  effectsOccurrence  of  CV  events  and  development/progression  of  kidney  or  other  organ  impairmentPatient  adherence  to  treatment  plan  using  multiple  sources  of  information*Collaborate  with  patient,  caregivers,  and  other  health  professionals  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/18
UR  - accesspharmacy.mhmedical.com/content.aspx?aid=1148578332
ER  -