Name the category.
Immunomodulators
Name the main drugs.
PREDNISOLONE (covered elsewhere)
Ciclosporin (covered elsewhere)
Azathioprine
What kind of immunomodulator class is azathioprine?
Purine analog
Describe the mechanism of action.
Purine analog (antimetabolite precursor of 6-mercaptopurine ) → ↓ nucleotide synthesis → ↓ proliferation of lymphocytes
Cytostatic effect at a high dosage via inhibition of cell proliferation
Immunosuppressive effect at a low dosage with significant inhibition of lymphocyte proliferation
Does it supress the cell-mediated and humoral immune response?
Yes and (Yes)
List indications
Prophylaxis against renal transplant rejection
Autoimmune disease treatment (e.g., rheumatoid arthritis, Crohn disease, glomerulonephritis)
To wean patients off long-term steroid therapy
Steroid-refractory disease
List adverse effects.
Pancytopenia
Hepatotoxicity
Malignancies
Pancytopenia and following immunosuppression mainly occurs when MP is administered with xanthine oxidase inhibitors (e.g., allopurinol)
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