Azathioprine- Pre-administration
- Check TPMT levels
- Catalyzes S-methylation of thiopurine drugs (azathioprine, 6-mercaptopurine, 6-thioguanine)
- Defects => decreased inactivation of 6MP leading to enhanced bone marrow toxicity
- 10% have reduced activity => Reduce dose
- 0.3% have no activity => Contraindication
- Adverse effects
- B: N+V, Generally unwell
- C: Rash, Hepatitis, Pancreatitis, Bone marrow suppression, Photosensitivity
- D: SCC, BCC, Lymphoma
- Monitoring
- Weekly FBC, LFTs, U+Es
- Then 3-monthly
Notes - UC can actually cause upstream constipation if disease is predominantly left-sided => Laxatives
- UC can cause a hypercoagulable state
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