Adverse effects of corticosteroids and immunosuppressants
Adverse effects of corticosteroids and immunosuppressants ( 5 Questions)
A nurse is teaching a client who has Crohn's disease and is prescribed azathioprine (Imuran), an antimetabolite. What are some of the adverse effects that the nurse should watch for?
Infection due to suppression of the immune system and increased susceptibility to opportunistic pathogens such as fungi, viruses, bacteria, and parasites . Azathioprine is an antimetabolite that works by suppressing the immune system and reducing inflammation. It is used to treat Crohn's disease, a chronic inflammatory condition of the digestive tract that causes symptoms such as abdominal pain, diarrhea, weight loss, and fever. Azathioprine can reduce the ability of the immune system to fight off infections and increase the risk of serious or fatal infections. The nurse should instruct the client to monitor their temperature and white blood cell count regularly and report any signs of infection (such as fever, chills, sore throat, cough, or wound drainage) to their doctor. The nurse should also advise the client to avoid contact with people who have infections and to receive prophylactic antibiotics or antifungals as prescribed.
Gastrointestinal effects such as nausea, vomiting, diarrhea, ulceration, and bleeding due to irritation or erosion of the gastric mucosa, and hepatotoxicity due to metabolic stress on the liver . Azathioprine is an antimetabolite that works by interfering with the synthesis of nucleic acids, which are essential for cell division and replication. Azathioprine can affect the rapidly dividing cells of the gastrointestinal tract and cause gastrointestinal effects such as nausea, vomiting, diarrhea, ulceration, and bleeding. Azathioprine can also affect the liver and cause hepatotoxicity such as elevated liver enzymes, jaundice (yellowing of skin or eyes), hepatitis (inflammation of liver), or liver failure. The nurse should instruct the client to take azathioprine with food or milk to reduce stomach irritation and to drink plenty of fluids to prevent dehydration. The nurse should also instruct the client to monitor their liver function tests regularly and report any signs of liver injury (such as nausea, vomiting, anorexia (loss of appetite), fatigue, dark urine, or clay-colored stools) to their doctor.
Bone marrow suppression such as anemia (low red blood cell count), leukopenia (low white blood cell count), thrombocytopenia (low platelet count) due to interference with the synthesis of nucleic acids . Azathioprine is an antimetabolite that works by interfering with the synthesis of nucleic acids, which are essential for cell division and replication. Azathioprine can affect the rapidly dividing cells of the bone marrow and cause bone marrow suppression such as anemia, leukopenia, thrombocytopenia. These conditions can cause symptoms such as fatigue, weakness, pallor (pale skin), shortness of breath, increased susceptibility to infection, bruising, bleeding, or petechiae (small red spots on skin). The nurse should instruct the client to monitor their blood counts regularly and report any abnormal results or signs of bone marrow suppression to their doctor. The nurse should also advise the client to avoid activities that may cause injury or bleeding and to use caution when using sharp objects or dental floss.
Skin reactions such as rash, pruritus (itching), alopecia (hair loss), and photosensitivity (increased sensitivity to sunlight) due to hypersensitivity or allergic response to the drug . Azathioprine is an antimetabolite that can cause skin reactions such as rash, pruritus, alopecia. Azathioprine is an antimetabolite that can cause skin reactions such as rash, pruritus, alopecia, and photosensitivity due to hypersensitivity or allergic response to the drug . The nurse should instruct the client to stop taking azathioprine and seek immediate medical attention if they experience any severe or persistent skin reactions. The nurse should also inform the client that they may develop a delayed hypersensitivity reaction after several weeks or months of treatment that may manifest as fever, rash, joint pain, or lymph node enlargement. The nurse should instruct the client to report any of these symptoms to their doctor as well . The nurse should also advise the client to protect their skin from sun exposure by wearing sunscreen, hats, sunglasses, and clothing and to avoid tanning beds or lamps.
The nurse should monitor the client for signs and symptoms of these adverse effects and intervene as appropriate. The nurse should also educate the client about the importance of adhering to the prescribed dosage and schedule of azathioprine and not to stop or change the dose without consulting their doctor. The nurse should also remind the client to follow up with their doctor regularly and to have periodic blood tests to check their blood counts, liver function, and immune status.
A. Infection due to suppression of the immune system and increased susceptibility to opportunistic pathogens such as fungi, viruses, bacteria, and parasites . Azathioprine is an antimetabolite that works by suppressing the immune system and reducing inflammation. It is used to treat Crohn's disease, a chronic inflammatory condition of the digestive tract that causes symptoms such as abdominal pain, diarrhea, weight loss, and fever. Azathioprine can reduce the ability of the immune system to fight off infections and increase the risk of serious or fatal infections. The nurse should instruct the client to monitor their temperature and white blood cell count regularly and report any signs of infection (such as fever, chills, sore throat, cough, or wound drainage) to their doctor. The nurse should also advise the client to avoid contact with people who have infections and to receive prophylactic antibiotics or antifungals as prescribed.
B. Gastrointestinal effects such as nausea, vomiting, diarrhea, ulceration, and bleeding due to irritation or erosion of the gastric mucosa, and hepatotoxicity due to metabolic stress on the liver . Azathioprine is an antimetabolite that works by interfering with the synthesis of nucleic acids, which are essential for cell division and replication. Azathioprine can affect the rapidly dividing cells of the gastrointestinal tract and cause gastrointestinal effects such as nausea, vomiting, diarrhea, ulceration, and bleeding. Azathioprine can also affect the liver and cause hepatotoxicity such as elevated liver enzymes, jaundice (yellowing of skin or eyes), hepatitis (inflammation of liver), or liver failure. The nurse should instruct the client to take azathioprine with food or milk to reduce stomach irritation and to drink plenty of fluids to prevent dehydration. The nurse should also instruct the client to monitor their liver function tests regularly and report any signs of liver injury (such as nausea, vomiting, anorexia (loss of appetite), fatigue, dark urine, or clay-colored stools) to their doctor.
C. Bone marrow suppression such as anemia (low red blood cell count), leukopenia (low white blood cell count), thrombocytopenia (low platelet count) due to interference with the synthesis of nucleic acids . Azathioprine is an antimetabolite that works by interfering with the synthesis of nucleic acids, which are essential for cell division and replication. Azathioprine can affect the rapidly dividing cells of the bone marrow and cause bone marrow suppression such as anemia, leukopenia, thrombocytopenia. These conditions can cause symptoms such as fatigue, weakness, pallor (pale skin), shortness of breath, increased susceptibility to infection, bruising, bleeding, or petechiae (small red spots on skin). The nurse should instruct the client to monitor their blood counts regularly and report any abnormal results or signs of bone marrow suppression to their doctor. The nurse should also advise the client to avoid activities that may cause injury or bleeding and to use caution when using sharp objects or dental floss.
D. Skin reactions such as rash, pruritus (itching), alopecia (hair loss), and photosensitivity (increased sensitivity to sunlight) due to hypersensitivity or allergic response to the drug . Azathioprine is an antimetabolite that can cause skin reactions such as rash, pruritus, alopecia. Azathioprine is an antimetabolite that can cause skin reactions such as rash, pruritus, alopecia, and photosensitivity due to hypersensitivity or allergic response to the drug . The nurse should instruct the client to stop taking azathioprine and seek immediate medical attention if they experience any severe or persistent skin reactions. The nurse should also inform the client that they may develop a delayed hypersensitivity reaction after several weeks or months of treatment that may manifest as fever, rash, joint pain, or lymph node enlargement. The nurse should instruct the client to report any of these symptoms to their doctor as well . The nurse should also advise the client to protect their skin from sun exposure by wearing sunscreen, hats, sunglasses, and clothing and to avoid tanning beds or lamps.
The nurse should monitor the client for signs and symptoms of these adverse effects and intervene as appropriate. The nurse should also educate the client about the importance of adhering to the prescribed dosage and schedule of azathioprine and not to stop or change the dose without consulting their doctor. The nurse should also remind the client to follow up with their doctor regularly and to have periodic blood tests to check their blood counts, liver function, and immune status.