Immuno-modulators (Immunosuppressant Drugs)

Question 1

Examples of drug (Immunosuppressant Drugs)

Answer 1

• Methotrexate
• Azathioprine
• Mercaptopurine

Question 2

Mechanism of action (Immunosuppressant Drugs)

Answer 2

• Disrupt DNA synthesis
• Azathioprine: blocks purine synthesis mainly in lymphocytes
• Methotrexate: stops the action of the enzyme dihydrofolate needed for production of DNA

Question 3

Indications (Immunosuppressant Drugs)

Answer 3

• Post transplantation immunosuppression
• Inflammatory bowel disease
• Renal vasculitis
• Paediatric leukaemia (methotrexate is used)

Question 4

Side effects (Immunosuppressant Drugs)

Answer 4

• Bone marrow suppression (leucopenia)
• Risk of infection
• Nephrotoxicity
• Hepatotoxicity
• Seizures
• GI upset
• Mucosal ulceration
• Alopecia

Question 5

Important pharmacokinetics/pharmacodynamics (Immunosuppressant Drugs)

Answer 5

• Do not cross the blood brain barrier
• Undergo hepatic metabolism
• Oral absorption is dose dependent
• Patients with low levels of thiopurine methyltransferase activity are more prone to azathioprine and mercaptopurine related marrow suppression

Question 6

Patient information (Immunosuppressant Drugs)

Answer 6

• Limit caffeine intake

- Take without regard to meals