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The Pharmacological Management of Lupus

The Pharmacological Management of Lupus

The Pharmacological Management of Lupus

QUESTION
For this assignment, you will write a paper on the pharmacological management of the disease. The paper should include a review of the:

Select a disease process that is of interest to you.
Pathophysiology of the disease state.
Review of the pharmacological agents used for treatment and important information related to advanced practice nurse.
Each student will clearly write a title for this topic: For examples, “Pharmacological Effects of Anti-Hypertensive Medications in the Management of Hypertension”.

Due in module 7.

Submission Instructions:

The paper is to be clear and concise and students will lose points for improper grammar, punctuation, and misspelling.
The paper should be formatted per current APA and 5-7 pages in length, excluding the title, abstract and references page.
Incorporate a minimum of 5 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.
Complete and submit the assignment by 23:59 Sunday.
Late work policies, expectations regarding proper citations, acceptable means of responding to peer feedback, and other expectations are at the discretion of the instructor.
The Pharmacological Management of Lupus

ANSWER

The Pharmacological Management of Lupus
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The Pharmacological Management of Lupus
Introduction
Lupus is a systemic body condition whereby one’s immune system attacks its body organs and tissues. It may lead to attacks and inflammation in organs such as the heart, kidney, and liver by limiting their functionality. The signs exhibited by lupus resemble those of other diseases, and thus, it is difficult to diagnose it. Some of the signs exhibited are rashes on the skin, headaches, and confusion. Once diagnosed, however, advanced nurses may manage it by administering several pharmacological agents. There is no distinct cure for lupus, but the patients may easily manage the condition by adhering to pharmacological medications as prescribed. Below is a brief overview of the disease etiology, pathophysiology, and detailed insight into lupus’ pharmacological management. Also highlighted in the paper is the role of advanced nurses in the effective pharmacological management of lupus.
Overview of The Signs and Symptoms and Causes of Lupus
As mentioned above, lupus’s signs and symptoms are hard to diagnose as they resemble those of other diseases. The most distinct symptom is the butterfly-shaped rashes on the cheeks. The signs and symptoms of lupus develop slowly and may be mild or acute. Some may disappear after a while; other symptoms may be permanent. As reported in most infected populations, most persons experience flares. That is, when the symptoms may appear and then disappear entirely for a while. However, the most common signs are skin and face rashes, pain in the joints, headaches, mild fever, fatigue, and chest pain. Other patients may also report instances of memory loss or prolonged bouts of confusion (Gasser & Schell-Chaple, 2020). The complexity and similarity of the above symptoms to other conditions making the accurate diagnosis of lupus problematic. Individuals who have combinations of the above symptoms need to seek medical attention, especially after the development of rashes and other defining symptoms such as rheumatic joints pain. (Deng et al. 2019).
The Pathophysiology of Lupus
This condition is characterized by the immune system attacking the body tissues. Lupus is a multigene condition developed from a combination of a person’s genes and their environment. Rather than produce the antibodies to fight off infections, the body produces autoantibodies that adversely react with the body’s organs and tissues. The autoimmune reaction results in the formation of complexes of antigen-antibody that accumulate in tissues and may lead to swelling. (Deng et al. 2019).
Antinuclear antibodies are found in all lupus erythematosus patients, and examples include anti-Sm and anti-double-stranded DNA antibodies. They attack the Smit antigen and the DNA, respectively (Taheri et al. 2020). Some autoantibodies, such as anti-Ro and anti-La found in lupus or Sjogren syndrome patients, contribute to photosensitivity issues and the development of skin rashes when exposed to UV light. Moreover, there are anti-phospholipids antibodies that destroy the cell membrane and may lead to blood clots, cardiac attacks, and increased chances of having a stroke. After an accurate diagnosis of the disease and confirmation of the critical symptoms such as facial rashes, one may be treated using the pharmacological agent described below.
The Pharmacological Treatment of Lupus
There is no distinct cure for lupus. However, the treatment strategies employed are aimed at managing the symptoms. The treatment of systemic lupus focuses on reducing the pain, controlling the swelling, and trying as much to limit the damage of vital organs. Several medications are prescribed depending on the type of lupus and the vital organs affected. For example, methylprednisolone and other forms of glucocorticoids are taken for managing the inflammation. They may be administered orally but with the adherence to the dosages provided by the advanced practice nurses. Other drugs, such as cytotoxic medications, may be administered to suppress the immune activity. Common examples of these immunosuppressants are methotrexate or cyclophosphamide.
Furthermore, antimalarial are effective treatments for managing some of the symptoms of lupus. They are utilized to manage rashes, joint pains, and mouth ulcers. Antimalarial drugs are useful, especially where inflammation and blood clotting is an issue.
The primary mechanism used by antimalarial drugs such as Aralen and hydroxychloroquine is decreasing the production of autoantibodies. This manages UV light effects on the skin by enhancing the skin lesions. However, antimalarial drug effects are gradual compared to those of steroids, and changes may be witnessed after almost a month. The side effects of these antimalarial drugs range from gastrointestinal complications to eye problems (Dörner & Furie, 2019). The immunosuppressant’s medications may be taken to control the overactivity of the immune system. They are used in the event of the failure of steroids to manage the lupus symptoms.
In the treatment of lupus, the caregiver should carefully monitor the progress of the patients. Notably, the immunosuppressant reduces the body’s ability to ward off infections. Thus the patient is under a high risk of being infected with viral conditions such as herpes zoster and chickenpox (Morel, 2017). Therefore, the patient ought to report any mild or significant changes in their bodies to the physician. As research suggests, using these drugs may also make one susceptible to different forms of cancer. Patients should pay attention to signs such as swelling and redness. Note that a qualified physician should prescribe the immunosuppressant due to the severity of the side effects. Other medications that may be used are anticoagulants that are used to control blood clots in lupus patients. Blood clotting is a fatal lupus symptom that leads to blood thinning. Examples of these drugs include Calciparine, Warfarin, and Liquaemin. The anticoagulation therapies may be administered for the entire lifecycle for some people with lupus. In the use of drugs such as warfarin, the nurses must consider the patients’ genetic makeup. As research suggests, those with differences in two genes need to take low doses of warfarin based on how the body breaks down the warfarin.
Monoclonal antibodies such as Benlysta are also used in the pharmacologic management of lupus symptoms. The monoclonal antibodies are artificially made and designed to locate and attach to one body part/. Recent studies show that Benlysta can minimize the levels of autoantibodies and manage disease activity.
Besides, Repository Corticotrophin Injection, the H.P. Acthar Gel, may be administered to manage lupus. It contains an adrenocorticotropic hormone that enables the body to produce its own steroid, such as cortisol. They benefit the immune system by preventing swelling. These hormones may assist your immune system by helping your body defend itself against inflammation (Xie, et al, 2020).
Role of The Advanced Practice Nurse in The Pharmacological Management of Lupus
The advanced practice nurse may advise the patients to avoid the stimulating factors that lead to recurrence. Several contemporary approaches to therapy may also be recommended to manage the condition and allow patients to have a normal life. When dealing with patients with a history of preexisting conditions such as hypertension, the nurses should understand that lupus can be triggered by several forms of antibiotics, hypertension, and anti-seizure medications. Besides, in the use of drugs like coagulants such as warfarin, the APN needs to individualize the treatment plan due to significant genetic differences that may impact the drug’s effect. Moreover, the APN is mandated to monitor patients’ progress under the medication and advise and assist them in leading lifestyles that limit the triggering of lupus symptoms.
Conclusion
From statistics, lupus continues to be a deadly disease that affects a significant part of the population. Being a multigenic disease that exhibits symptoms resembling other conditions, its accurate diagnosis needs keenness from a qualified physician. Pharmacological management of lupus includes administering immunosuppressants, corticosteroids, monoclonal antibodies, and anticoagulants to manage the symptoms. These medications reduce inflammation and damage to vital organs such as the lungs, kidney, and cardiovascular system. Advanced practice nurses assisting in managing lupus patients need to monitor the progress keenly and individualize the treatment approach.

References
Deng, J., Chalhoub, N. E., Sherwin, C. M., Li, C., & Brunner, H. I. (2019, October). Glucocorticoids pharmacology and their application in the treatment of childhood-onset systemic lupus erythematosus. In Seminars in arthritis and rheumatism (Vol. 49, No. 2, pp. 251-259). WB Saunders.
Dörner, T., & Furie, R. (2019). Novel paradigms in systemic lupus erythematosus. The Lancet, 393(10188), 2344-2358.
Gasser, E. K., & Schell-Chaple, H. M. (2020). Systemic Lupus Erythematosus and Critical Illness. AACN Advanced Critical Care, 31(3), 296-307.
Morel, L. (2017). Immunometabolism in systemic lupus erythematosus. Nature reviews Rheumatology, 13(5), 280-290.
Taheri, M., Eghtedarian, R., Dinger, M. E., & Ghafouri-Fard, S. (2020). Exploring the role of non-coding RNAs in the pathophysiology of systemic lupus erythematosus. Biomolecules, 10(6), 937.
Xie, B., Geng, Q., Xu, J., Lu, H., Luo, H., Hu, Y., & Song, X. (2020). The multi-targets mechanism of hydroxychloroquine in the treatment of systemic lupus erythematosus based on network pharmacology. Lupus, 0961203320952541.

The Pharmacological Management of Lupus

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