Immunosuppressants

Key Points

• Immunosuppressants reduce immune activity to prevent organ rejection or control autoimmune disease.
• Increased infection risk is the primary and most dangerous adverse effect.
• Classes include calcineurin inhibitors (cyclosporine, tacrolimus), antimetabolites (azathioprine, mycophenolate), and mTOR inhibitors.
• Close monitoring of drug levels, renal function, and CBC is essential.

Mechanism

Immunosuppressants interrupt specific immune pathways. Calcineurin inhibitors block T-cell activation signals. Antimetabolites inhibit DNA synthesis in rapidly dividing immune cells. Corticosteroids suppress broad inflammatory cascades.

Key Nursing Considerations

• Monitor for infection signs — fever, neutropenia, unusual pathogens.
• Check drug levels (especially cyclosporine, tacrolimus) to prevent nephrotoxicity.
• Teach patients to avoid live vaccines and minimize exposure to infectious contacts.
• Monitor CBC, renal function, and liver enzymes regularly.

Related Concepts

• active-and-passive-immunity - Immune system context for immunosuppression.
• glomerulonephritis - Common indication for immunosuppressive therapy.