メディカルスタッフレクチャー
免疫抑制薬投与中の患者管理について
キーワード:
immunosuppressive agents,
neuro–immunological diseases,
pregnancy,
breast–feeding,
hepatitis virus
2019 年 36 巻 4 号 p. 422-427
詳細
2019 年 36 巻 4 号 p. 422-427
Immunosuppressive agents are administered to neuro–immunological diseases such as multiple sclerosis, myasthenia gravis, neuromyelitis optica, vasculitic neuropathy. Attention should be paid to the complication and exacerbation of infection due to the immunosuppressive action of these drugs. Monitoring of the concentration in blood of the drugs is also useful as a countermeasure against side effects.
Neuro–immunological diseases are prevalent in women of childbearing age, and administration of immunosuppressive agents must always consider risks to mothers and fetuses. In June 2018, the Ministry of Health, Labor and Welfare in Japan approved the use of 3 drugs such as tacrolimus, azathioprine and ciclosporin for pregnant women, “Contraindication to pregnant women” was removed from the package insert.
In recent years, fulminant hepatitis with hepatitis B virus due to administration of immunosuppressive agents or sudden withdrawal has attracted attention and “Guidelines” has been prepared in Japan. It had described the screening methods and countermeasures and it is necessary to be informed.
In clinical practice, if patients treated with immunosuppressive drugs complain of unusual symptoms, it is required to deal with side effects of this drug in a timely manner.
