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7 Cards in this Set

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describe azathioprine & mercaptopurine
thiopurine immunomodulatory (potent antiinflammatory) drugs (azathioprine is converted to mercaptopurine). both inhibit purine synthesis & gene replication in rapidly dividing cells
what are the possible side effects of azathioprine & mercaptopurine?
1. macrocytosis & lymphopenia (don't need to stop therapy)
2. nausea, vomiting, diarrhoea, fever, headache, malaise, rash, myalgia, joint pain - can mimic exacerbation of illness
3. impaired liver function, renal function, pancreatitis, bone marrow toxicity, hair loss, skin cancers
why should allupurinol be avoided in patients taking azathioprine or mercaptopurine?
allupurinol inhibits xanthine oxidase, which metabolises azathioprine/mercaptopurine
what monitoring is needed for patients taking azathioprine or mercaptopurine
LFTs
FBCs (lymphopenia, bone marrow suppression)
cyclosporin mechanism of action
inhibits cytokine release from activated T cells
adverse effects of cyclosporin
most common: reversible renal impairment, hypertension
others: hirsutism, gum hypertrophy, hepatic dysfunction, burning hands & feet, pancreatitis, hyperlipidaemia, oedema, weight gain, haematological disturbances, CNS disturbance (headache, tremor), hyperkalaemia, hypermagnaesemia, hyperuricaemia, increased rate of malignancies
what monitoring is needed for cyclosporin?
baseline FBC, LFT, EUC, fasting lipids, BP
Annual skin check