Nursing/ Medical Interventions:
Education on nature of the disease, modes of therapy, diagnostic procedures, pregnancy risk, and immunization information * Sustain optimal weight * Pain Control * Oral Cares * Treat lesions * Reduce risk of infection * Reduce inflammation * Sustain joint function * Encourage rest periods * Reduce any fluid retention or edema * Provide support |
History and Physical Exam
Antibodies (anti-DNA, anti-Sm, ANA) Complete Blood Cell Count LE cell prep Serum complement levels Urinalysis X-ray of affected joints Chest x-ray ECG to determine extraarticular involvement |
Medication TherapyNSAIDs are commonly prescribed for patients with SLE because many will develop arthralgias or polyarthritis.
Systemic glucocorticoids can be used alone or in combination with other immunosuppressive agents. These are typically reserved for patients with significant organ involvement, particularly renal or CNS. Antimalarials are used to treat and prevent flares and are particularly useful for arthralgias that are not adequately controlled with NSAIDs. Hydroxychloroquine is most commonly used. Cytotoxic/immunosuppressive agents are used for patients who are not responsive to antimalarials or glucocorticoids should be considered for treatment with immunosuppressive agents for more severe manifestations of the disease. This can include cyclophosphamide, azathioprine, mycophenolate mofetil, and methotrexate. Belimumab is a monoclonal antibody which is made to target and destroy only certain cells in the body and help to protect healthy cells from damage. |