Immunosuppressants

Question 1

Cyclosporine/azathioprine

Answer 1

Low WBC and Low platelets
Contraindicated in pregnancy
Gingival hyperplasia ( cyclosporine)
No grapefruit juice
Avoid crowds
Use soft toobrush ( due to gum bleeding risk)

Question 2

Cyclosporine

Answer 2

For organ transplant, take med for life
HCP will evaluate blood work regularly
Take med same time everyday

Question 3

Tumor necrosis factor inhibitors

Answer 3

Etanercept, influximab & adalimumab Report increase WBC and fever
TB reactivation ( make sure negative TB before starting and also yearly)
No live vaccines ( herpes zoster or shingles)
Contraindicated in chronic, reoccurring or recent infection

Question 4

Hydrochloroquine

Answer 4

Used in lupus (autoimmune to skin and joints) decrease inflammation and fatigue
Long onset of action(months)

Can cause eye toxicity (retinal and vision) so check eye every 6-12 months

Question 5

Methotrexate

Answer 5

Rheumatoid arthritis (autoimmune to bones)
Psoriasis (autoimmune to skin)
Blocks folic acid in fast growing cells such as blood
Contraindicated in pregnancy, hard toothbrush, crowds etc
Avoid fresh fruits
Infection and bleeding risk
Report petechie (bleeding under skin), purpura(purple) and melena (black), bleeding gums etc