Drug-Induced Lupus Erythematosus

-

DILE may be induced by medications or caused by other compounds in the environment.
DILE may be induced by medications or caused by other compounds in the environment. 
The most common drugs that cause drug-induced SLE are 
  •        hydralazine (rate roughly 20%), 
  •        procainamide (rate roughly 20%, 5-8% if taken for 1 y), 
  •        quinidine,
  •        isoniazid, 
  •        minocycline.
Drugs most commonly associated with drug-induced SCLE include 
  •       calcium-channel blockers, 
  •       angiotensin-converting enzyme inhibitors, 
  •       thiazide diuretics,
  •       terbinafine, 
  •       TNF-alpha antagonists.

Several broad drug categories have been linked to DILE, including the following:
  • Antiarrhythmics - Procainamide and quinidine
  • Antibiotics – Minocycline and isoniazid
  • Antifungals - Griseofulvin and voriconazole
  • Anticonvulsants - Valproate, ethosuximide, carbamazepine, and hydantoins
  • Hormonal therapy - Leuprolide acetate
  • Antihypertensives - Hydralazine, methyldopa, and captopril
  • Anti-inflammatories - Penicillamine and sulfasalazine
  • Antipsychotics - Chlorpromazine
  • Cholesterol-lowering agents - Lovastatin, simvastatin(DISCLE), atorvastatin, and gemfibrozil
  • Biologics - Interleukins (eg, IL-2), interferons (eg, alfa, beta, gamma), and TNF-α (etanercept, infliximab, adalimumab)
  • Inhalers - Tiotropium bromide inhaler
  • Other drug categories - Ophthalmic timolol
Additional drugs that may cause DILE include the following:
  • Acebutolol
  • Amiodarone (SLE and SCLE)
  • Atenolol
  • Bupropion
  • Cefepime
  • Diltiazem
  • Docetaxel
  • Doxorubicin (DISCLE)
  • Doxycycline (DISCLE)
  • Esomeprazole (DISCLE)
  • Fluorouracil
  • Glyburide
  • Gold salt
  • Hydroxychloroquine
  • Imiquimod (DISCLE)
  • Lamotrigine
  • Lansoprazole (DISCLE)
  • Lithium
  • Mephenytoin
  • Nitrofurantoin
  • Olanzapine
  • Omeprazole (DISCLE)
  • Oral contraceptives
  • Phenytoin
  • Practolol
  • Propylthiouracil
  • Reserpine
  • Rifampin
  • Rifamycin
  • Sertraline
  • Tetracycline
  • Ticlopidine
  • Trimethadione
A genetic predisposition may play a role. Hydralazine-induced DILE has been observed with increased frequency in association with human leukocyte antigen (HLA)-DR4.
Intrinsic genetic susceptibility may help explain why some patients experience DILE as a reaction to drug therapies, whereas others do not. For example, the rate of acetylation is genetically predetermined. In the United States, the population is almost evenly divided between those who are fast acetylators and those who are slow acetylators. Those with slow acetylation rates have a higher prevalence of DILE than those with faster acetylation rates. In contrast, SLE affects individuals with slow and fast acetylation rates approximately equally.
Other causes may induce DILE in certain individuals for no apparent reason, such as sensitivity to the following:
  • Insecticide compounds
  • Certain metallic compounds
  • Eosin (a fluorescent acid dye found in some lipsticks)
Drugs that cause flares of SLE are as follows:

Comments

Post a Comment

Popular posts from this blog

Paints in pharmacy| glycerin borax preparation is the first

-
Image
(1) GLYCERIN BORAX PREPARATION 13% Borax 13gm Glycerin to 100ml Levigate the borax powder into a suitable amount of glycerin then complete to 100ml.  Glycerin of borax uses: Used as a soothing agent in mouth ulcers also used in nipple fissures. (2) GLYCERIN TANNIC ACID PAINT 15% Tannic acid 15gm Glycerin to 100 ml Astringent in spongy gum and sore throat and applied to eyelid in trachoma. 1g of Na-citrate can be added (3) Glycerin borax and Tr.benzoin SOLUTION Glycerin borax 20 ml Tr.benzoin 10 ml Used in nipple fissure (4) DENTAL GLYCERIN ( zinc chloride) ZnCL2 1gm Glycerin 1.6ml H2O 0.5ml Alcohol 1.5ml used for de-sensation for exposed dentin (5) GENTIAN VIOLET PAINT (Rosaniline dyes) Gentian violet 1 gm Alcohol 70% 100 ml Used as antiseptic and in moniliasis. 2g of G. V can be used with 100 ml of glycerin borax in breast fissures. (6) ALCOHOLIC MERCUROCHROME PAINT Mercurochrome 2gm Alcohol 70% to 100 ml (7) Mercurochrome
Read more

Drops and washes [glycerin phenol ear drops]

-
Image
(1) GLYCERIN BICARBONATE EAR DROPS Na bicarbonate 5 gm Glycerin 33 gm Water to 100 ml Dissolve bicarbonate in water Used for washing out ear wax. (2) HYDROGEN PEROXIDE EAR DROPS H2O2 vol 10 5 ml Water to 100 ml Must be freshly prepared & used as antiseptic. (3) GLYCERIN PHENOL EAR DROP Phenol 10 gm Glycerin to 100 ml Glycerin phenol ear drops use: Used as antiseptic, antifungal, antibacterial. N.B. diluted with the same volume of glycerin to be used for children. (4) ALKALINE NASAL WASH NaHCO3 NaCl a.a Borax (5) MENTHOL NASAL DROPS (Menthol Paraffin) Menthol 10gm Eucalyptus 2ml Camphor 10gm Liquid paraffin to 100ml Used as a nasal decongestant. (6) ALUMINIUM ACETATE EAR DROPS 13% aluminium acetate in water  used to decrease oedema and inflammation by producing an acidic environment (7) BORIC ACID EAR DROPS (ALCOHOLIC EAR DROPS) Boric acid 4gm Alcohol 90% 100ml Dissolve boric acid in hot alcohol. (8) ARGYROL (SILVER PROTEINAT
Read more

Pharmacy Examining Board of Canada Questions & Answers

-
Image
Overview Q1 What is the Pharmacy Examining Board of Canada? The Pharmacy Examining Board of Canada ( PEBC ) is the national certification body for the pharmacy profession in Canada. PEBC is a non-profit organization with more than 40 years of experience in assessing the qualifications and competence of candidates for licensing by pharmacy provincial regulatory authorities. Established by Special Act of Parliament on December 21,1963, PEBC functions as an arms-length national examining board for pharmacists seeking entry-to-practice licensure in Canada. Q2 What is the purpose of the PEBC?
Read more