Azathioprine

Question 1

What may occur in patients during the start of treatment with azathioprine?

Answer 1

Drowsiness may occur

Patients should be informed about the potential for drowsiness, especially at the beginning of treatment.

Question 2

What should be monitored for patients on azathioprine?

Answer 2

Full blood count, renal function, liver function

Regular monitoring is essential to assess the patient’s health status while on therapy.

Question 3

List warning signs for patients taking azathioprine.

Answer 3

• Hypotension
• Nausea and vomiting
• Unexplained bruising or bleeding
• Infection

Patients should be educated about these warning signs to ensure timely medical intervention.

Question 4

What actions are required if malaise, dizziness, or diarrhoea occurs in azathioprine patients?

Answer 4

Seek medical attention

Patients should report any significant symptoms such as malaise, dizziness, fever, myalgia, or rash.

Question 5

In what scenario should the azathioprine dose be reduced?

Answer 5

In elderly patients or those taking concurrent allopurinol

Special consideration is needed for these populations to minimize adverse effects.

Question 6

What should be measured before initiating therapy with azathioprine?

Answer 6

Thiopurine methyltransferase (TPMT) activity

This measurement helps assess the risk of myelosuppression in patients.

Question 7

What is the risk for patients with absent TPMT activity regarding thiopurine drugs?

Answer 7

They should not receive thiopurine drugs

Patients with reduced TPMT activity should be treated under specialist supervision.

Question 8

What effect do coumarins have when taken with azathioprine?

Answer 8

Anticoagulant effect is reduced

This interaction could affect the therapeutic outcomes for patients on anticoagulant therapy.

Question 9

What should patients report immediately while on azathioprine?

Answer 9

Signs of bone marrow suppression

This includes unexplained bruising, bleeding, or signs of infection.

Question 10

What is the increased risk associated with ACE inhibitors when taking azathioprine?

Answer 10

Anaemia and/or leucopenia

This risk necessitates careful monitoring and management.

Question 11

What is the risk of live vaccines in patients on azathioprine?

Answer 11

Increased risk of generalised infection

This could be life-threatening and should be discussed with patients.