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Management of complications of immunosuppressants

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Dr Vinay Keshavamurthy, Chandigarh    23 January 2019

  • Prevention better than cure:

o  Identify patients at risk of adverse effects

o  Baseline evaluation

o  Regular clinical and laboratory monitoring

o  Drugs: PPI, Folic acid.

  • Most immunosuppressants can be safely administered in patients with HCV and occult HBV. Acute HBV infection requires treatment prior to immunosuppression.
  • IGRA is the preferred screening method for latent tubercular infection among Indians. INH and RCIN treatment for at least 1 month prior to immunosuppression.
  • All immunosuppressed patients should receive pneumococcal and annual influenza vaccine. Preferably VZV also prior to immunosuppression.

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