Immunosuppressants

Immunosuppressants are drugs or medicines that lower the body's ability to reject a transplanted organ. Another term for these drugs is anti-rejection drugs. There are 2 types of immunosuppressants:

Induction drugs: Powerful antirejection medicine used at the time of transplant
Maintenance drugs: Antirejection medications used for the long term.

1. immunosuppressant
IMMUNOSUPPRESSANTS
By
Ms. Preeti
SMVDCoN

2. IMMUNOSUPPRESSION
•Immunosuppressioninvolvesanact
thatreducestheactivationorefficacy
oftheimmunesystem.Someportions
oftheimmunesystemitselfhave
immuno-suppressiveeffectsonother
partsoftheimmunesystem,and
immunosuppressionmayoccurasan
adversereactiontotreatmentofother
conditions.

3. IMMUNOSUPPRESSANT
•Animmunosuppressantisanyagent
thatcausesimmunosuppression,
includingimmunosuppressivedrugs
andsomeenvironmentaltoxins.One
of the primary usesof
immunosuppressantdrugsistolower
thebody’sabilitytorejecta
transplantedorgan,suchasaliver,
heartorkidney.

4. IMMUNOSUPPRESSANT
•These are the drugs, which prevent
or lesson the immune response of
the body.
•Uses
•Widely used to treat autoimmune
disorders and to prevent tissue
rejection after organ
transplantations.

5. Commonly used Drugs
Cyclosporine
(sandimmune)
Mycophenolaten
mofetil (cell
cept)
Tacrolimus (
FK506,Prograf)
Azathiprine
(imuran)
Muromanab-
CD3 (orthoclone
OKT3)

6. CONTRAINDICATION
Administration alone with vaccine or combination
immunosuppressive therapy can cause serum
sickness.
Side effects
•Infection
•Irritation at the site of administration
•Anemia
•Thrombocytopenia
•GI distress

7. Nursing implication
•Avoid extravasations at IV site.
•Monitor frequently for super
infection
•Avoid administering oral form in
empty stomach
•Monitor liver functions and blood
count periodically.
•Assess for transplant rejection
,report fever more than 99 F

8. IMMUNOMODULATING AGENTS:
•Thesearethedrugs,whichcan
stimulatecellularimmunesystem,
enhancemultiplicationofactivated
killerT-cellandprotectbone
marrowcellbybindingtoreceptors
onbonemarrowcellinvolvedin
productionofneutrophils.

9. Commonly used class of drugs
Interleukins
Colony-
stimulating
factors
interferons

10. INTERLEUKINS
•InterleukinsenhancetherateofB-
cellandactivatedkiller–Tcell
productionthatrecognizescancer
cellsasforeignanddestroythem,
butignoresnormalcell.

11. USES OF INTERLEUKINS
•Thesedrugshavelimitedusesin
treatingHodgkin’scancerofthe
femalereproductiveorgansand
lungcancers.
•Effectiveintreatmentofcolorectal
adenocarcinoma,renalcell
carcinoma and malignant
melanomas.

12. COMMONALY USED DRUGS ARE
ALDESLEUKIN (PROLEUKIN)
•Side effects :
•Capillaryleakingsyndrome-capillaries
loosetheiressentialcomponent
(protein)intothesurroundingthat
causesfluidretentionwithedema.
•Congestivecardiacfailureand
arrhythmias,secondarythefluid
retention.
•Flu-likesymptoms.

13. INTERACTIONS
CHEMOTHERA -
PEUTIC
AGENTS
ANTIBIOTICS
CORTICOSTE
ROIDS
ANTIHYPERT
ENSIVE

14. NURSING IMPLICATIONS
•Monitor fluid
intake and
output.
•Use non opoidal
analgesic to treat
flu-like
symptoms.

15. COLONY-STIMULATING FACTORS
•CSFsbindtoreceptors
onbonemarrowcells
and inhibit
neutropeniacausedby
chemotherapeutic
agents.
•Theyarealsoknownto
stimulatingimmune
cellsthatdestroy
viruses,fungiand
tumorcells.

16. USES
•Usedinthetreatmentofviral
andfungalinfections.
•Followingbonemarrow
transplantation.
•Usedincombinationwith
chemotherapeuticagents,to
reducetheincidenceof
neutropenia.

17. COMMONALY USED DRUGS
•Epoitinalfa
( human recombinant erthropoeitin)
Side effects:
•Hypertension and dyspnea, secondary
fluid retention.
•G.I. distress

18. NURSING IMPLICATIONS
•Monitorfluidretention
andBP.
•Assesslungsoundsfor
pulmonaryedema.

19. INTERFERONS
•Interferonspossessantineoplasticand
antiviralpropertiesbydirectlyinhibitingthe
synthesisofDNAandprotein.
•Theyalsohaveabilitytoincreasethecell
surfaceantigenonthetumorcell,thus
enablingtheimmunesystemtorecognize
tumorcell.Theyalsostopviralpenetration
intohealthycellsandreplications.

20. USES
•Treatmentofmultiple
sclerosis (autoimmune
disease)
•Treatmentofviralinfections
suchas,condyloma(STDof
virus)viralhepatitis,
papillomavirus,retrovirus
andrhinovirus.

21. COMMONLY USED DRUGS
Interferon-alfa,beta and gamma
Side
effects
GI distress
Flu-like
distress
Allergy
Liver
toxicity
Renal
toxicity
Dizziness

22. NURSING IMPLICATIONS
•Take the history of allergy to
egg or egg product. If the
person is allergic avoid
administration of these drugs.
•Implement safety measures if
confusion or dizziness is
reported.
•Monitor renal and liver
functions periodically by
laboratory parameters.

23. THANK YOU