Immune disorders are present in the pathogenesis of most rheumatic immune diseases, and immunosuppressants are a conventional weapon in the treatment of rheumatic immune diseases. Immunosuppressants are drugs that have an inhibitory effect on the immune response of the body, inhibit the proliferation and function of cells related to the immune response (macrophages such as T cells and B cells), and can reduce the antibody immune response. Immunosuppressants are mainly used for autoimmune diseases such as rheumatoid arthritis, lupus erythematosus, dermatomyositis, polymyositis and vasculitis. Commonly used immunosuppressants include methotrexate, leflunomide, cyclophosphamide and azathioprine, cyclosporine, tacrolimus, mycophenolate, etc. The correct and reasonable use of immunosuppressants can significantly improve the condition of patients with immune-related rheumatic diseases, but their side effects should not be ignored.
1, the use of immunosuppressants principles
1) before taking: perfect hepatitis B and half, hepatitis C antibody, liver and kidney function and blood and urine routine, under the guidance of specialist physicians with.
2) Regular check of blood and urine routine and liver and kidney function: once every 2 weeks for the first 3 months, and once every 1-3 months thereafter, and seek medical attention in case of abnormalities, and discontinue the drug in a timely manner in serious cases.
3) You should not get pregnant while taking the drug, and you should stop taking the drug for at least half a year before you can get pregnant.
2.Prevention of liver damage
1) liver protection drugs: hepatica, vitamin C, silymarin, ezetimibe, etc.
2)Drink more honey: protects the liver, improves resistance to infection, also contains insulin-like substances, nourishes Yin and moistens dryness, nourishes the middle and moistens the lungs, also suitable for patients with stable diabetes.
3) “High protein” and “adequate calories” is the dietary principle, but patients with severe disease and high blood ammonia should not eat too much high protein food, so as not to aggravate the kidney function.
4) Eat less barbecue, pickled and high-fat foods.
5) Do not eat pig liver to supplement the liver: animal liver contains toxins that damage the liver; high copper content causes accumulation in the liver and brain, causing jaundice and anemia, etc.
6) Do not drink alcohol.
3, prevention and control of white blood cell reduction
1) high protein, low fat, high calorie, high vitamin diet: such as fish, chicken, lean pork, eggs, milk, fresh vegetables and fruits, etc., with a 1:1-2:1 ratio of vegetable fat to animal fat.
2) foods that help to raise white blood cells: goose blood, duck blood, royal jelly, jujube, lingzhi, yam, cordyceps, eggs, turtle, peanuts, and silver fungus.
3) Avoid partial diet, smoking, alcohol and spicy food.
4) If necessary, use leukocyte-raising drugs as appropriate under the guidance of doctors: such as vitamin B4, vitamin B6, inosine, shark’s liver alcohol, leucovorin, coenzyme A, rhG/Gm-CSF, etc.
4, prevention and control of thrombocytopenia
1) light diet: no stimulating food, reduce seafood, fungus, grapes and lamb and other blood-activating foods.
2) can eat: peanuts, red dates stewed pig’s feet; Agaricus; boiled peanut skin water.
3) maintain emotional stability.
4) If necessary: use platelet-raising drugs as appropriate under the guidance of a doctor: such as platelet-raising capsules, ching qi fuzheng capsules, recombinant human thrombopoietin injection, recombinant interleukin 11; immunoglobulin; hormones, etc.
5. Drugs that can be used to prevent side effects
1) Methotrexate users: take 5-10mg of folic acid on the 3rd day of methotrexate (avoid taking it on the same day as it will lead to methotrexate failure), which can reduce cumulative toxicity such as oral ulcers, gastrointestinal reactions and liver damage, but is not effective for atopic bone marrow suppression and pulmonary fibrosis.
2) Those using cyclophosphamide: should take the drug in the morning after meals; drink a lot of water and empty the bladder frequently; repeatedly measure red blood cells in the urine to be alert to the occurrence of hemorrhagic cystitis.
3) Those who use Leflunomide: blood pressure should be monitored daily; if high blood pressure is monitored several times, antihypertensive drugs can be used under the guidance of physicians.
6. Precautions for taking hydroxychloroquine
1) Use small doses, the vast majority of no side effects, but still need to pay attention to observation.
2)Check the fundus and cornea etc. at the ophthalmology department about 1 year.
3)Check electrocardiogram once a year or so, it is prohibited for those who have atrioventricular block.
4) Foreign reports that taking this drug can be pregnant.
7. Precautions for taking salazosulfapyridine tablets
1) Drink more water.
2)Do not use if you are allergic to sulfonamide.
3)Do not be afraid if the urine is yellow.
4)Check blood and urine routine and liver and kidney function regularly.