Final year‎ > ‎

13.09.19 Gastroenterology + other notes

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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