Immunosuppressants for autoimmune diseases: Nursing pharmacology

Autoimmune diseases occur when the immune system mistakenly attacks various tissues and organs around the body, such as in systemic lupus erythematosus and rheumatoid arthritis.

Often there are periods of illness, called flares, and periods of remission during which there are few or no symptoms. Unfortunately, autoimmune diseases can’t be cured, but their symptoms can be treated with a variety of systemic immunosuppressant medications.

Okay, immunosuppressants to treat autoimmune diseases include corticosteroids like prednisone or dexamethasone, monoclonal antibodies like belimumab, immunomodulators like azathioprine, antimetabolites like methotrexate, and antimalarials like hydroxychloroquine.

These medications can be taken orally, or injected as intravenously, intramuscularly, or less commonly, subcutaneously. Once administered, immunosuppressants primarily work by blunting the inflammatory process so that it can’t cause damage to healthy tissues, and preventing or limiting the severity of flares.

Unfortunately, some of these medications can also increase the risk of side effects like bone marrow suppression, which can lead to anemia, thrombocytopenia, and leukopenia, as well as increased risk for infections. Some clients may also experience drowsiness, fatigue, and gastrointestinal disturbances, such as anorexia, nausea, vomiting, and diarrhea.