Azathioprine
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Musculoskeletal Drugs
- Corticosteroids
- Acetaminophen
- Azathioprine
- Sulfasalazine
- TNF Inhibitors
- Immunosuppressants (Cyclosporine, Mycophenolate, Tacrolimus)
- NSAIDs
- Colchicine
- Allopurinol
- Rasburicase
- Dantrolene
- Muscle Relaxants
- Bisphosphonates: Alendronate, Risedronate
Summary
Azathioprine is an immunosuppressant drug used to treat autoimmune diseases like lupus and irritable bowel syndrome, among others. Azathioprine is also used to prevent organ transplant rejection. A major side effect to know is bone marrow suppression, which can manifest as a reduction of red blood cells, white blood cells, and platelets.
Key Points
- Azathioprine (Imuran)
- Also known as AZA
- Mechanism
- Immunosuppressant
- Purine antimetabolite
- Blocks purine metabolism and DNA synthesis, suppressing T- and B-lymphocyte proliferation
- Purine antimetabolite
- A precursor to the drug 6-MP (6-mercaptopurine)
- Immunosuppressant
- Clinical Uses
- Autoimmune conditions
- Systemic Lupus Erythematosus (SLE)
- Irritable bowel syndrome (IBS)
- Ulcerative colitis
- Myasthenia Gravis
- Prevention of organ transplant rejection
- Most commonly used post-kidney transplant
- Autoimmune conditions
- Side Effects and Adverse Reactions
- Bone Marrow Suppression
- Also known as myelosuppression
- Can lead to anemia (low red blood cells)
- Can lead to thrombocytopenia (low platelets)
- Can lead to leukopenia (low white blood cells)
- Severe, adverse reaction that should be reported to provider
- Increased when taken with antihypertensives
- Increased risk of infection
- Should not receive live vaccines
- A CBC, including platelet count, should be monitored
- Nausea and fatigue
- Hepatotoxicity
- Liver enzymes should be monitored during treatment
- Bone Marrow Suppression