The Official Patient's Sourcebook on Lupus (21 page)

procedures and/or therapies can take many years to develop after the thesis

that proposed the new technique or approach was written.

In this chapter, we will give you a bibliography on recent dissertations

relating to lupus nephritis. You can read about these in more detail using the Internet or your local medical library. We will also provide you with

information on how to use the Internet to stay current on dissertations.

Dissertations on Lupus Nephritis

ProQuest Digital Dissertations
is the largest archive of academic dissertations available. From this archive, we have compiled the following list covering

dissertations devoted to lupus nephritis. You will see that the information

provided includes the dissertation’s title, its author, and the author’s

institution. To read more about the following, simply use the Internet

address indicated. The following covers recent dissertations dealing with

lupus nephritis:

·
Contributions to the Pathology of Kidney, Liver and Other Diseases

(helicobacter Pylori)
by Sinniah, Rajalingam; Dsc from Queen's

University of Belfast (northern Ireland), 2001

http://wwwlib.umi.com/dissertations/fullcit/f461793

112 Lupus Nephritis

Keeping Current

As previously mentioned, an effective way to stay current on dissertations

dedicated to lupus nephritis is to use the database called
ProQuest Digital
Dissertations
via the Internet, located at the following Web address:

http://wwwlib.umi.com/dissertations.
The site allows you to freely access the last two years of citations and abstracts. Ask your medical librarian if the library has full and unlimited access to this database. From the library, you

should be able to do more complete searches than with the limited 2-year

access available to the general public.

Vocabulary Builder

Helicobacter:
A genus of gram-negative, spiral-shaped bacteria that is pathogenic and has been isolated from the intestinal tract of mammals,

including humans. [NIH]

113

PART III. APPENDICES

ABOUT PART III

Part III is a collection of appendices on general medical topics which may be

of interest to patients with lupus nephritis and related conditions.

Researching Your Medications 115

APPENDIX A. RESEARCHING YOUR MEDICATIONS

Overview

There are a number of sources available on new or existing medications

which could be prescribed to patients with lupus nephritis. While a number

of hard copy or CD-Rom resources are available to patients and physicians

for research purposes, a more flexible method is to use Internet-based

databases. In this chapter, we will begin with a general overview of

medications. We will then proceed to outline official recommendations on

how you should view your medications. You may also want to research

medications that you are currently taking for other conditions as they may

interact with medications for lupus nephritis. Research can give you

information on the side effects, interactions, and limitations of prescription drugs used in the treatment of lupus nephritis. Broadly speaking, there are

two sources of information on approved medications: public sources and

private sources. We will emphasize free-to-use public sources.

116 Lupus Nephritis

Your Medications: The Ba
sics42

The Agency for Health Care Research and Quality has published extremely

useful guidelines on how you can best participate in the medication aspects

of lupus nephritis. Taking medicines is not always as simple as swallowing a

pill. It can involve many steps and decisions each day. The AHCRQ

recommends that patients with lupus nephritis take part in treatment

decisions. Do not be afraid to ask questions and talk about your concerns. By

taking a moment to ask questions early, you may avoid problems later. Here

are some points to cover each time a new medicine is prescribed
:

· Ask about all parts of your treatment, including diet changes, exercise,

and medicines.

· Ask about the risks and benefits of each medicine or other treatment you

might receive.

· Ask how often you or your doctor will check for side effects from a given

medication.

Do not hesitate to ask what is important to you about your medicines. You

may want a medicine with the fewest side effects, or the fewest doses to take

each day. You may care most about cost, or how the medicine might affect

how you live or work. Or, you may want the medicine your doctor believes

will work the best. Telling your doctor will help him or her select the best

treatment for you.

Do not be afraid to “bother” your doctor with your concerns and questions

about medications for lupus nephritis. You can also talk to a nurse or a

pharmacist. They can help you better understand your treatment plan. Feel

free to bring a friend or family member with you when you visit your doctor.

Talking over your options with someone you trust can help you make better

choices, especially if you are not feeling well. Specifically, ask your doctor the following:

· The name of the medicine and what it is supposed to do.

· How and when to take the medicine, how much to take, and for how

long.

· What food, drinks, other medicines, or activities you should avoid while

taking the medicine.

· What side effects the medicine may have, and what to do if they occur.

· If you can get a refill, and how often.

42 This section is adapted from AHCRQ:
http://www.ahcpr.gov/consumer/ncpiebro.htm
.

Researching Your Medications 117

· About any terms or directions you do not understand.

· What to do if you miss a dose.

· If there is written information you can take home (most pharmacies have

information sheets on your prescription medicines; some even offer

large-print or Spanish versions).

Do not forget to tell your doctor about all the medicines you are currently

taking (not just those for lupus nephritis). This includes prescription

medicines and the medicines that you buy over the counter. Then your

doctor can avoid giving you a new medicine that may not work well with

the medications you take now. When talking to your doctor, you may wish

to prepare a list of medicines you currently take, the reason you take them,

and how you take them. Be sure to include the following information for

each:

· Name of medicine

· Reason taken

· Dosage

· Time(s) of day

Also include any over-the-counter medicines, such as:

· Laxatives

· Diet pills

· Vitamins

· Cold medicine

· Aspirin or other pain, headache, or fever medicine

· Cough medicine

· Allergy relief medicine

· Antacids

· Sleeping pills

· Others (include names)

Learning More about Your Medications

Because of historical investments by various organizations and the

emergence of the Internet, it has become rather simple to learn about the

118 Lupus Nephritis

medications your doctor has recommended for lupus nephritis. One such

source is the United States Pharmacopeia. In 1820, eleven physicians met in

Washington, D.C. to establish the first compendium of standard drugs for

the United States. They called this compendium the “U.S. Pharmacopeia

(USP).” Today, the USP is a non-profit organization consisting of 800

volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in

Rockville, Maryland, and its home page is located at
www.usp.org
. The USP

currently provides standards for over 3,700 medications. The resulting USP

DIÒ Advice for the PatientÒ can be accessed through the National Library of

Medicine of the National Institutes of Health. The database is partially

derived from lists of federally approved medications in the Food and Drug

Administration’s (FDA) Drug Approvals database.
43

While the FDA database is rather large and difficult to navigate, the

Phamacopeia is both user-friendly and free to use. It covers more than 9,000

prescription and over-the-counter medications. To access this database,

simply type the following hyperlink into your Web browser:

http://www.nlm.nih.gov/medlineplus/druginformation.html
. To view

examples of a given medication (brand names, category, description,

preparation, proper use, precautions, side effects, etc.), simply follow the

hyperlinks indicated within the United States Pharmacopoeia. It is important

to read the disclaimer by the United States Pharmacopoeia

(
http://www.nlm.nih.gov/medlineplus/drugdisclaimer.html
) before using

the information provided.

Of course, we as editors cannot be certain as to what medications you are

taking. Therefore, we have compiled a list of medications associated with the

treatment of lupus nephritis. Once again, due to space limitations, we only

list a sample of medications and provide hyperlinks to ample documentation

(e.g. typical dosage, side effects, drug-interaction risks, etc.). The following drugs have been mentioned in the Pharmacopeia and other sources as being

potentially applicable to lupus nephritis:

Corticosteroids

·
Dental - U.S. Brands:
Kenalog in Orabase; Orabase-HCA; Oracort;

Oralone

http://www.nlm.nih.gov/medlineplus/druginfo/corticosteroidsd

ental202010.html

43 Though cumbersome, the FDA database can be freely browsed at the following site:
www.fda.gov/cder/da/da.htm
.

Researching Your Medications 119

·
Inhalation - U.S. Brands:
AeroBid; AeroBid-M; Azmacort;

Beclovent; Decadron Respihaler; Pulmicort Respules; Pulmicort

Turbuhaler; Vanceril; Vanceril 84 mcg Double Strength

http://www.nlm.nih.gov/medlineplus/druginfo/corticosteroidsi

nhalation202011.html

·
Nasal - U.S. Brands:
Beconase; Beconase AQ; Dexacort Turbinaire;

Flonase; Nasacort; Nasacort AQ; Nasalide; Nasarel; Nasonex;

Rhinocort; Vancenase; Vancenase AQ 84 mcg; Vancenase

pockethaler

http://www.nlm.nih.gov/medlineplus/druginfo/corticosteroidsn

asal202012.html

·
Ophthalmic - U.S. Brands:
AK-Dex; AK-Pred; AK-Tate; Baldex;

Decadron; Dexair; Dexotic; Econopred; Econopred Plus; Eflone;

Flarex; Fluor-Op; FML Forte; FML Liquifilm; FML S.O.P.; HMS

Liquifilm; Inflamase Forte; Inflamase Mild; I-Pred; Lite Pred;

Maxidex; Ocu-Dex; Ocu-Pred; Ocu-Pr

http://www.nlm.nih.gov/medlineplus/druginfo/corticosteroidso

phthalmic202013.html

·
Otic - U.S. Brands:
Decadron

http://www.nlm.nih.gov/medlineplus/druginfo/corticosteroidso

tic202014.html

·
Rectal - U.S. Brands:
Anucort-HC; Anu-Med HC; Anuprep HC;

Anusol-HC; Anutone-HC; Anuzone-HC; Cort-Dome; Cortenema;

Cortifoam; Hemorrhoidal HC; Hemril-HC Uniserts; Proctocort;

Proctosol-HC; Rectosol-HC

http://www.nlm.nih.gov/medlineplus/druginfo/corticosteroidsr

ectal203366.html

Commercial Databases

In addition to the medications listed in the USP above, a number of

commercial sites are available by subscription to physicians and their

institutions. You may be able to access these sources from your local medical

library or your doctor’s office.

Reuters Health Drug Database

The Reuters Health Drug Database can be searched by keyword at the

hyperlink:
http://www.reutershealth.com/frame2/drug.html
. The following 120 Lupus Nephritis

medications are listed in the Reuters’ database as associated with lupus

nephritis (including those with contraindications):
44

·
Quinidine

http://www.reutershealth.com/atoz/html/Quinidine.htm

Mosby’s GenRx

Mosby’s GenRx database (also available on CD-Rom and book format)

covers 45,000 drug products including generics and international brands. It

provides prescribing information, drug interactions, and patient information.

Information in Mosby’s GenRx database can be obtained at the following

hyperlink:
http://www.genrx.com/Mosby/PhyGenRx/group.html
.

Physicians Desk Reference

The Physicians Desk Reference database (also available in CD-Rom and book

format) is a full-text drug database. The database is searchable by brand

name, generic name or by indication. It features multiple drug interactions

reports. Information can be obtained at the following hyperlink:

http://physician.pdr.net/physician/templates/en/acl/psuser_t.htm
.

Other Web Sites

A number of additional Web sites discuss drug information. As an example,

you may like to look at
www.drugs.com
which reproduces the information

in the Pharmacopeia as well as commercial information. You may also want

to consider the Web site of the Medical Letter, Inc. which allows users to

download articles on various drugs and therapeutics for a nominal fee:

http://www.medletter.com/
.