Pharmaceutical Care

Q: The use of which of the following drugs has resulted in the development of a syndrome strongly resembling systemic lupus erythematosus (SLE)?

(a) :  pirbuterol (Maxair)
(b) :  lamotrigine (Lamictal)
(c) :  hydralazine (Apresoline)
(d) :  methyldopa (Aldomet)
(e) :  diazoxide (Hyperstat IV)
Answer:  hydralazine (Apresoline)
Explanation:   Chronic (longer than 6 months) high dose administration of hydralazine (Apresoline) may produce an acute rheumatoid state in approximately 10% of patients taking the drug. A syndrome clinically indistinguish able from disseminated lupus erythematosus develops in a smaller percentage of users. This lupus-like syndrome (fever, arthralgia, splenomegaly, edema, and the presence of lupus erythematosus cells in the peripheral blood) has also been associated with procainamide use.

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