immunosuppressive agent
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Function
- immunosuppression
- inhibition of autoimmunity
Laboratory
- liver function tests
- complete blood count every 3 months
- screening for tuberculosis, hepatitis B, hepatitis C & HIV1 infection prior to initiation of aggressive immunosuppressive therapy[1]*
- screening for viral infection & before or during immunosuppressive therapy[1][3]
- screening for tuberculosis
- surveillance for opportunistic infections
* antibiotic therapy must be started prior to initiation of immunosuppressive agent
Management
- vaccines
- avoid live virus vaccines with immunosuppressive therapy
- delay live virus vaccination 1-6 months after discontinuation of immunosuppressive therapy
- Shingrix vaccine recommended
- avoid live virus vaccines with immunosuppressive therapy
- infectious diseases
- may need to hold doses of immunosuppressive agents during infections that require antimicrobial therapy[1]
- discontinue immunosuppressive therapy if disseminated CMV infection[3]
- chemoprophylaxis after Pneumocystis jirovecii infection[3]
More general terms
More specific terms
- alefacept (Amevive)
- anti-thymocyte globulin (ATG)
- azathioprine (Azanin, Imuran, Imurel)
- basiliximab (Simulect)
- belatacept (Nulojix)
- belumosudil (Rezurock)
- biologic immunosuppressive agent (biologic agent, biologic immune modulator)
- cyclophosphamide (Cytoxan, Neosar, Procytox {Canadian}) [CPM, CTX, CYT, NSC 26271]
- cyclosporin A (Sandimmune, Neoral [CsA])
- daclizumab (Zinbryta)
- efalizumab (Raptiva)
- glucocorticoid
- mTOR inhibitor; target of rapamycin inhibitor
- mycophenolate (Cellcept, Myfortic)
- natalizumab (Tysabri)
- rhuMAB-E25
- risankizumab (Skyrizi)
- tacrolimus; FK506; fujimycin (Prograf, Advagraf, Envarsus XR)
- vedolizumab (Entyvio)
- voclosporin (Lupkynistm)
References
- ↑ Jump up to: 1.0 1.1 1.2 1.3 Medical Knowledge Self Assessment Program (MKSAP) 16, 17, 18. American College of Physicians, Philadelphia 2012, 2015, 2018
- ↑ Jump up to: 2.0 2.1 ARUP Consult: Immunosuppressive Drug Optimization and Monitoring - Organ Transplantation Drugs The Physician's Guide to Laboratory Test Selection & Interpretation https://www.arupconsult.com/content/organ-transplantation
- ↑ Jump up to: 3.0 3.1 3.2 3.3 European Crohn's and Colitis Organisation Infections in Inflammatory Bowel Disease Clinical Practice Guidelines (ECCO, 2021). Medscape. August 10, 2021 https://reference.medscape.com/viewarticle/956233
- ↑ Gago-Sanchez AI, Font P, Cardenas M, et al. Real clinical impact of drug-drug interactions of immunosuppressants in transplant patients. Pharmacol Res Perspect. 2021;9:e00892. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34755493