AZATHIOPRINE : used, Side effects, Dose,Pharmacodynamic & mechanism of action...

 AZATHIOPRINE 

BRAND NAME:-IMURAN, TRANSIMUNE ,AZOPRINE 50mg tab . 

AZATHIOPRINE is a antiproliferative & cytotoxic immunosuppressant drug.It reduces the action of body's own defense system (the immune system) and prevents rejection of the transplanted organ. It also blocks the action of certain chemical messengers that are responsible for inflammation, swelling, and redness associated with certain joint diseases.

Pharmacodynamic:-

Azathioprine is an immunosuppressive agent which functions through modulation of rac1 to induce T cell apoptosis, as well as other unknown immunosuppressive functions. It has a long duration of action as it is given daily, and has a narrow therapeutic index.Patients should be counselled regarding the risk of malignancies of the skin and lymphomas.

Mechanism of action:- 

 It is a purine antimetabolite which has more marked immunosuppressant than antitumour action . The basis for this difference is not clear, but may be due to its selective uptake into immune cells and intracellular conversion to the active metabolite 6-mercaptopurine, which then undergoes further transformations to inhibit de novo purine synthesis and damage to DNA . It selectively affects differentiation and function of T cells and inhibits cytolytic lymphocyte; CMI is primarily depressed. 

Dose:- 

Azathioprine 3-5mg/kg/day, maintenance 1-2mg /kg/day; as directed by your doctor.

Used :- 

To prevent organ rejection in people who have received a kidney transplant. It is usually taken along with other medications to allow your new kidney to function normally. Azathioprine is also used to treat rheumatoid arthritis. In this condition, the body's defense system (immune system) attacks healthy joints. Azathioprine belongs to a class of drugs known as immunosuppressants. It works by weakening the immune system to help your body accept the new kidney as if it were your own (in the case of an organ transplant) or to prevent further damage to your joints (in the case of rheumatoid arthritis).Talk to your doctor about the risks and benefits of azathioprine, especially when used by children and young adults.

SIDE EFFECTS:-

The more common side effects that occur with azathioprine include:

•low white blood cell counts

•Infections

•Stomach problems, including nausea, diarrhea, and vomiting 

WARNING ⚠️:-Azathioprine may cause a rare type of lymphoma (cancer) of the liver, spleen, and bone marrow that can be fatal. This has occurred mainly in teenagers and young men with Crohn's disease or ulcerative colitis.