قابل توجه بیماران کولیت وکرون
کولیت ورم روده کولیت زخمی مزالزین کرون اسکلروزینگ کلانژیت سولفا سالازین هیدروکورتیزون
پنتاشا اساکول ورم معده زخم معده کولیت تشعشعی پرد نیزلون عوارض جانبی داروها مجموعه بحثهایی است
میتوانید در ارشیو بطور مفصل مطالعه فرمایید
درمان
با ترک غذاهای ممنوعه جسمی چون چای وشکر ومشتقات ان و... ورعایت اداب غذاخوردن و پرهیز از غذاهای مضر روحی همچون عصبانیت و تنش و...
بیماری اگر چه سرطان باشد بتدریج مهار شده و سیستم ایمنی بدن خود به دفع بیماریها می پردازد (بدیهی است تا بازگشت
سلامتی کامل به سیستم ایمنی باید با دارو بیماری را کنترل ودرمان کرد.)
غذاهای ممنوعه
چای، قند و شکر، شیرینی جات قنادی، هر چیزی که با قند و شکر تهیه می شود. سرخ کردنی، فریز شده، زودپز شده. سس، رب، شور، ترشیجات، سرکه، نمک زیاد، لبنیات، مرغ و تخم مرغ ماشینی، غذاهای چرب و پرحجم، ماکارونی و لازانیا، کلیه غذاهای ساندویچی، همراه غذا مایعات. دوغ و نوشابه، تند و سریع غذا خوردن، آب یخ، بستنی، تنقلات مصنوعی، قهوه، نسکافه، غذای پخته شده با مایکروفر.
(توضیح انکه مصرف لبنبات محلی که ازشیر مطمئن در روستاها وگله داریهای مراتع وصحرا هابدست امده نه تنها مانعی ندارد
بلکه توصیه هم شده است .(
علاوه بر ترک تدریجی غذاهای ممنوعه روحی چون عصبانیت وخودخوری و کینه دلی حسادت و...وغذاهای ممنوعه جسمی مثل چای وقند وشکر وغذاهای غیر طبیعی و....
برای استمرار سلامتی هر فرد باید مزاج وطبع خود وغذاها رابشناسد
بطور کلی اطباء قدیم مزا جها را به 4 گروه تقسیم کرده اند
صفراوی
دموی
بلغمی
سوداوی
مزاج انسان تابع غذایی است که میخورد بنابراین مزاج انسان مرتب تغییر میکند برای هر مزاجی نشانه هایی است با دیدن ان نشانه ها هرکس میتواند مزاج خود رابشناسد وبا تغییر در غذا انرا متعادل کند
طبع کلا سه گونه است ودر طول عمر ثابت است
طبع گرم
طبع سرد
طبع معتدل
وغذاها نیز سه دسته هستند گرم وسرد و معتدل
هرفرد میتواند براحتی طبع ومزاج خود را بشناسد وغذاهایی که با طبعش مناسب است انتخاب ومصرف کند
درمان
با ترک غذاهای ممنوعه جسمی چون چای وشکر ومشتقات ان و... ورعایت اداب غذاخوردن و پرهیز از غذاهای مضر روحی همچون عصبانیت و تنش و...
بیماری اگر چه سرطان باشد بتدریج مهار شده و سیستم ایمنی بدن خود به دفع بیماریها می پردازد (بدیهی است تا بازگشت
سلامتی کامل به سیستم ایمنی باید با دارو بیماری را کنترل ودرمان کرد.)
غذاهای ممنوعه
چای، قند و شکر، شیرینی جات قنادی، هر چیزی که با قند و شکر تهیه می شود. سرخ کردنی، فریز شده، زودپز شده. سس، رب، شور، ترشیجات، سرکه، نمک زیاد، لبنیات، مرغ و تخم مرغ ماشینی، غذاهای چرب و پرحجم، ماکارونی و لازانیا، کلیه غذاهای ساندویچی، همراه غذا مایعات. دوغ و نوشابه، تند و سریع غذا خوردن، آب یخ، بستنی، تنقلات مصنوعی، قهوه، نسکافه، غذای پخته شده با مایکروفر.
(توضیح انکه مصرف لبنبات محلی که ازشیر مطمئن در روستاها وگله داریهای مراتع وصحرا هابدست امده نه تنها مانعی ندارد
بلکه توصیه هم شده است .(
درمان
با ترک غذاهای ممنوعه جسمی چون چای وشکر ومشتقات ان و... ورعایت اداب غذاخوردن و پرهیز از غذاهای مضر روحی همچون عصبانیت و تنش و...
بیماری اگر چه سرطان باشد بتدریج مهار شده و سیستم ایمنی بدن خود به دفع بیماریها می پردازد (بدیهی است تا بازگشت
سلامتی کامل به سیستم ایمنی باید با دارو بیماری را کنترل ودرمان کرد.)
غذاهای ممنوعه
چای، قند و شکر، شیرینی جات قنادی، هر چیزی که با قند و شکر تهیه می شود. سرخ کردنی، فریز شده، زودپز شده. سس، رب، شور، ترشیجات، سرکه، نمک زیاد، لبنیات، مرغ و تخم مرغ ماشینی، غذاهای چرب و پرحجم، ماکارونی و لازانیا، کلیه غذاهای ساندویچی، همراه غذا مایعات. دوغ و نوشابه، تند و سریع غذا خوردن، آب یخ، بستنی، تنقلات مصنوعی، قهوه، نسکافه، غذای پخته شده با مایکروفر.
(توضیح انکه مصرف لبنبات محلی که ازشیر مطمئن در روستاها وگله داریهای مراتع وصحرا هابدست امده نه تنها مانعی ندارد
بلکه توصیه هم شده است .(
.ویتامینهای گیاهی :اگر ویتامینها نباشند اندامها کار خودشان را درست انجام نمی دهند . رشته های عصبی مختل می شوند و سوخت وساز خوب انجام نمی شود . آنزیمها و هورمونها درست ساخته نمی شوند ویک سری بیماریهایی بوجود می آید که علتش کمبود ویتامین است . ویتامینها دو گروه هستند 1- محلول در چربی 2- محلول در آبمحلول در چربی ویتامینهای A+C+D+E+Kهستند همراه همه این ویتامینها باید روغن بخورید تا جذب شوند مثلا جوانه گندم را با روغن زیتون بخورید . اگر دوست نداشتید همراه مواد غذایی روغن زیتون بریزید باید حداقل قبل یا بعد از غذا روغن زیتون بخورید تا ویتامینها حل و جذب شوند .ویتامین A : هویج وکدو تنبل ویتامین A ندارد بلکه ماده رنگی آنها دربدن تبدیل به ویتامین A می شود ویتامین C: مرکبات و سبزیجات ویتامین C را دارند .ویتامین : D آفتاب معدن این ویتامینD می باشد . بهترین کرم برای پوست روغن زیتون یا روغن بادام است وخیلی سریع ویتامین D را جذب می کند و همیشه پوست شاداب است .ویتامین E : جوانه گندم دارای این ویتامین E می باشدویتامین K : برای انعقاد خون است ودر شبدر + یونجه وجود دارد ودر روده بزرگ ما هم تولید می شود .ویتامینهای محلول در آب :اکثر ویتامینها در سبزیجات و پوست میوه ها هستند و دور می ریزید .آنها را دورنریزید تا طبخال هم نگیرید . علت طبخال کمبود ویتامین دربدن است که دراثرشوک عصبی که به شما وارد می شود به کبد فشار زیادی وارد شده و یکدفعه ازخواب بیدار می شوید ویا سرما می خورید و طبخال می گیرید . حتی موقع سبزی پاک کردن سبزی را خرد نکنید تا ویتامینهای آنها در آب حل نشود . سبزی راخرد می کنید و می شوئید ودر فریزر می گذارید و تبدیل به چایی کرده و می پزید وخاکستر چایی می شود و می خورید و فکر می کنید که خوبست . ویتامین های B ( B1+B2+B5+B6+B7+B9+B12 )جزو این نوع ویتامینهای محلول درآب بوده و ومنشاء گیاهی دارند وهمچنین با خوردن غذاهای گیاهی در روده بزرگ ما تولید می شوند و شیرینی قنادی و قندو شکر ضد ویتامین B هستند. این ویتامینها در نشاط و سلامت پوست فوق العاده مؤثر هستند . ویتامینهای B بیشتر منشا آنها سبزیجات و پوست میوه ها و پوست غلات هستند وگندم پوست کنده استفاده نکنید . نان سفید خوشتان نیاید . بلغوری که یک بار پخته و پوستش هم ( در اثر مرطوب کردن موقع خرد کردن ) کنده شده استفاده نکنید . سعی کنید خود گندم را استفاده کنید . اگر غلات پوست کنده استفاده می کنید لااقل پوست غلات را هم به رژیم غذائیتان اضافه کنید . ما پوست دوم برنج را برای پختن برنج استفاده می کنیم . برنج سفید عاری از ویتامین B است ولی برنج که اول ازپوست در می آید قهوه ای است پوست برنج را اگرداخلش بریزید اثرات برنج سفید را خنثی می کند و آن را خوشمزه می کند و الکل زیاد درروده ایجاد نمی شود و گروه ویتامینهای B را دارد
برای رفع اسهال بزرگسالان
24 ساعت در جای خنک دراز کشیده استراحت کنید
جز اندکی نان خشک خانگی با کمی پنیر وارد نعناع خشک هیچ غذایی نخورید
یک پارچ اب سالم بهداشتی کنار خود بگذارید وهر ربع ساعت سه جرعه از ان را بایک نفس عمیق میان
هر جرعه بنوشید
اگر هوس میوه کردید یک دانه سیب درختی را کامل با پوست و تخمه خوب جویده بخورید
اگر تکرر دفع کم شد وبر حجم ادرار وشدت ان اضافه شد نشانه بهبودی است این رویه را تا سه روز
ادامه دهید وبعدا بتدریج رژیم غذایی خود را بحالت طبیعی برگردانید
اگر بعد از 24 ساعت تغییری در حجم ادرار ویا تکرر اجابت مزاج صورت نگرفت
قرص ید کینول که فعلا در داروخانه هاست (پزشکان بخصوص سی سال پیش قرص direxiod شرکت دلالاند فرانسه را برای معالجه انواع اسهالهاازجمله اسهالهای التهابی وخونی و...تجویز میکردند) یدوکینول تقریبا مشابه ان است بگیرید ودو عدد باهم با یک لیوان اب بخورید دوعدد هم شب بخورید اگر بعداز 24 ساعت اسهال کنترل نشد برای تشخیص دقیق بیماری به یک پزشک متخصص که مسن با تجربه یا جوان ومشهور وبا حوصله باشد رجوع کنید اسهال ممکن است نشانه بیماری التهاب روده یا سندرم روده تحریک پذیر یا شروع در گیری کبد باشد
Information You Should Know About HUMIRA® (adalimumab)
HUMIRA is a medicine called a Tumor Necrosis Factor (TNF) blocker. HUMIRA is used to:
• Reduce the signs and symptoms of:
o moderate to severe rheumatoid arthritis (RA) in adults. HUMIRA can be used alone or with methotrexate or with certain other medicines. HUMIRA may prevent further damage to your bones and joints and may help your ability to perform daily activities.
o moderate to severe polyarticular juvenile idiopathic arthritis (JIA) in children 4 years of age and older. HUMIRA can be used alone or with methotrexate or with certain other medicines.
o psoriatic arthritis (PsA) in adults. HUMIRA can be used alone or with certain other medicines. HUMIRA may prevent further damage to your bones and joints and may help your ability to perform daily activities.
o ankylosing spondylitis (AS) in adults.
o moderate to severe Crohn’s disease (CD) in adults who have not responded well to conventional treatments. HUMIRA is also for these adults who have lost response or are unable to tolerate infliximab.
• Treat moderate to severe chronic (lasting a long time) plaque psoriasis (Ps) in adults who have the condition in many areas of their body and who may benefit from taking injections or pills (systemic therapy) or phototherapy (treatment using ultraviolet light alone or with pills).
Important Safety Information you should know about HUMIRA® (adalimumab).
Serious infections have happened in patients receiving HUMIRA. These infections include TB (tuberculosis) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some patients have died from these infections.
Before starting HUMIRA:
Tell your doctor if you think you have an infection, are being treated for an infection, have signs of an infection (such as a fever, cough, or flu-like symptoms), have any open sores on your body, have warm, red, or painful skin, get a lot of infections or have infections that keep coming back, have or had hepatitis B infection, take the medicine Kineret (anakinra), have TB or have been in close contact with someone who has TB, have lived in an area where TB or histoplasmosis is common, or were born in, lived in or traveled where there is more risk for getting TB. Your doctor should test you for TB before starting HUMIRA. If your doctor prescribes any medicine for the treatment of TB, you should start taking it before starting HUMIRA and take the full course of TB medicine prescribed.
Tell your doctor if you have any numbness or tingling, or have a disease that affects your nervous system such as multiple sclerosis or Guillian-Barré syndrome, have heart failure or other heart conditions, are scheduled for major surgery, are pregnant, become pregnant, plan to become pregnant or are breastfeeding. Tell your doctor if you are allergic to HUMIRA or any of its ingredients or are allergic to rubber or latex. The needle cover of the prefilled syringe and the pen contain dry natural rubber.
Also, tell your doctor if you have recently received or are scheduled for any vaccines. Except for live vaccines, patients may still receive vaccines while on HUMIRA. It is recommended that children with juvenile idiopathic arthritis be brought up to date with all immunizations prior to starting HUMIRA.
After starting HUMIRA:
Call your doctor right away if you get an infection, or any sign of an infection including a fever, feeling very tired, cough, flu-like symptoms, warm, red or painful skin or if you have any open sores on your body. HUMIRA can make you more likely to get infections or make any infection that you may have worse.
Possible side effects of HUMIRA:
Serious side effects, which sometimes lead to death, have happened in patients taking HUMIRA.
• Serious infections. These infections include TB (tuberculosis) and infections caused by viruses, fungi, or bacteria. Your doctor will examine you for TB and perform a test to see if you have TB. If your doctor feels that you are at risk for TB, you may be treated with medicine for TB before you begin treatment with HUMIRA and during treatment with HUMIRA. Even if your TB test is negative your doctor should carefully monitor you for TB infections while you are taking HUMIRA. Patients who had a negative TB skin test before receiving HUMIRA have developed active TB. Tell your doctor if you have any of the following symptoms while taking or after taking HUMIRA: cough, low-grade fever, weight loss, or loss of body fat and muscle.
• Certain types of cancer. There have been cases of certain kinds of cancer in patients taking HUMIRA or other TNF blockers. Patients with RA, especially more serious RA, may have a higher chance for getting a kind of cancer called lymphoma. Some patients receiving HUMIRA have developed types of cancer called non-melanoma skin cancer (basal cell cancer and squamous cell cancer of the skin), which are generally not life threatening if treated. Tell your doctor if you have a bump or open sore that doesn’t heal.
• Allergic reactions. Signs of a serious allergic reaction include skin rash, a swollen face, or trouble breathing.
• Hepatitis B virus reactivation in patients that carry the virus in their blood. Tell your doctor if you have any of the following symptoms: feel unwell, poor appetite, fatigue, fever, rash or joint pain.
• Nervous system problems. Signs and symptoms include: numbness or tingling, problems with your vision, weakness in your arms or legs, and dizziness.
• Blood problems. Symptoms include a fever that does not go away, bruising or bleeding very easily, or looking very pale.
• New heart failure or worsening heart failure you already have. Symptoms include shortness of breath or swelling of your ankles or feet, or sudden weight gain.
• Immune reactions including a lupus-like syndrome. Symptoms include chest discomfort or pain that does not go away, shortness of breath, joint pain, or rash on your cheeks or arms that gets worse in the sun.
Call your doctor or get medical care right away if you develop any of the above symptoms. Your treatment with HUMIRA may be stopped.
Common side effects of HUMIRA are: injection site reactions (redness, rash, swelling, itching or bruising), upper respiratory infections (sinus infections), headaches, rash and nausea.
These are not all the side effects with HUMIRA. Ask your doctor or pharmacist for more information.
made with a healthcare provider and consider the unique characteristics of each patient.
Immuno-modulators are medications that affect the body"s immune system. The immune system is composed of immune cells and the proteins that they produce. These cells and proteins serve to protect the body against harmful bacteria, viruses, fungi, and other foreign invaders. Activation of the immune system causes inflammation within the tissues where the activation occurs. (Inflammation is, in fact, an important mechanism used by the immune system to defend the body.) Normally, the immune system is activated only when the body is exposed to foreign invaders. In patients with Crohn"s disease and ulcerative colitis, however, the immune system is abnormally and chronically activated in the absence of any known invader.
Immuno-modulators decrease tissue inflammation by reducing the population of immune cells and/or by interfering with their production of proteins. Decreasing the activity of the immune system with immuno-modulators increases the risk of infections; however, the benefits of controlling moderate to severe Crohn"s disease usually outweigh the risks of infection due to weakened immunity. Examples of immuno-modulators are 6-mercaptopurine (6-MP), azathioprine (Imuran), methotrexate (Rheumatrex, Trexall), infliximab (Remicade), adalimumab (Humira).
Azathioprine (Imuran) and 6-mercaptopurine (6-MP, Purinethol) are medications that weaken the body"s immune system by reducing the population of a class of immune cells called lymphocytes. Azathioprine and 6-MP are related chemically. (Actually, azathioprine is converted into 6-MP within the body.) In high doses, these two drugs have been useful in preventing rejection of transplanted organs and in treating leukemia. In low doses, they have been used for many years to treat patients with moderate to severe Crohn"s disease and ulcerative colitis.
Azathioprine and 6-MP are increasingly recognized by doctors as valuable drugs in treating Crohn"s disease and ulcerative colitis. Some 70% of patients with moderate to severe disease will benefit from these drugs. Azathioprine and 6-MP are used primarily in the following situations:
1. Severe Crohn"s disease and ulcerative colitis not responding to corticosteroids.
2. The presence of undesirable corticosteroid-related side effects.
3. Corticosteroid dependency, a condition in which patients are unable to discontinue corticosteroids without developing relapses of their disease.
4. Maintenance of remission.
When azathioprine and 6-MP are added to corticosteroids in the treatment of Crohn"s disease not responding to corticosteroids alone, there may be an improved response. Also, smaller doses and shorter courses of corticosteroids may be able to be used. Some patients can discontinue corticosteroids altogether without experiencing relapses of their disease. This corticosteroid-lowering effect has earned azathioprine and 6-MP their reputation as "steroid-sparing" medications.
In Crohn"s disease patients with severe disease who suffer frequent relapses, 5-ASA may not be sufficient, and the more potent azathioprine and 6-MP will be necessary to maintain remissions. In the lower doses used to treat Crohn"s disease, the long-term side effects of azathioprine or 6- MP are less serious than those of long-term corticosteroids or repeated courses of corticosteroids.
Patients with Crohn"s disease may undergo surgery to remove a segment of the intestine that is obstructed or contains a fistula. After surgical removal of the diseased segments, the patients often will be free of disease and symptoms for a while, but many eventually will have their disease recur. During these recurrences, previously healthy intestine can become inflamed. Long-term 5-ASA (such as Pentasa) and 6-MP both are effective in reducing the chances of recurrence after surgery.
Anal fistulae can develop in some patients with Crohn"s disease. Anal fistulae are abnormal tracts (tunnels) that form between the small intestine or colon and the skin around the anus. Drainage of fluid and mucous from the opening of the fistula is a troublesome problem. These fistulae are difficult to treat and do not heal readily. Metronidazole (Flagyl) has been used with some success in promoting healing of these fistulae. In difficult cases, azathioprine and 6-MP may be successful in promoting healing.
Side effects of azathioprine and 6-MP
Side effects of azathioprine and 6-MP include increased vulnerability to infections, inflammation of the liver (hepatitis) and the pancreas (pancreatitis), and bone marrow toxicity (interference with the formation of cells that circulate in the blood).
The goal of treatment with azathioprine and 6-MP is to lower the body"s production of certain types of white blood cells (lymphocytes) in order to decrease the inflammation in the intestines; however, lowering the number of lymphocytes may increase vulnerability to infections. For example, in a group of patients with severe Crohn"s disease unresponsive to standard doses of azathioprine, raising the dose of azathioprine helped to control the disease, but two patients developed cytomegalovirus (CMV) infection. (CMV typically infects individuals with weakened immune systems such as patients with AIDS and cancer patients receiving chemotherapy).
Azathioprine and 6-MP can induce inflammation of the liver (hepatitis) and pancreas (pancreatitis). Pancreatitis typically causes severe abdominal pain and sometimes vomiting. Pancreatitis due to azathioprine or 6-MP occurs in 3%-5% of patients, usually during the first several weeks of treatment. Patients who develop pancreatitis should not receive either of these two medications again.
Azathioprine and 6-MP also suppress the bone marrow. The bone marrow is where the red blood cells, white blood cells, and platelets are made. Actually, a slight reduction in the white cell count during treatment is desirable since it suggests that the dose of azathioprine or 6-MP is high enough to have an effect; however, excessively low red or white blood cell counts indicates bone marrow toxicity. Therefore, patients on azathioprine or 6-MP should have periodic blood counts (usually every two weeks initially and then every three months during maintenance) to monitor the effect of the drugs on the bone marrow.
Patients on long-term, high dose azathioprine to prevent rejection of the kidney after kidney transplantation have an increased risk of developing lymphoma, a malignant disease of lymph cells. There is no evidence at present that long term use of azathioprine or 6-MP, in the lower doses used in Crohn"s disease, increases the risk of lymphoma, leukemia or other malignancies.
The use of azathioprine and 6-MP in pregnant women must be carefully considered. There are reports suggesting that the use of azathioprine or 6-MP in pregnancy is safer than once thought. The risk of continuing azathioprine or 6-MP during conception and pregnancy must be weighed against the risk of worsening disease if they are stopped. On the other hand, worsening disease has been shown clearly to be a significant risk to the fetus.
Other issues with azathioprine and 6-MP
One problem with 6-MP and azathioprine is their slow onset of action. Typically, full benefit of these drugs is not realized for three months or longer. During this time, corticosteroids frequently have to be maintained at high levels to control inflammation.
The reason for this slow onset of action is partly due to the way doctors prescribe these drugs. For example, 6-MP is typically started at a dose of 50 mg daily. The blood count is then checked two weeks later. If the lymphocytes are not reduced, the dose of 6-MP is increased. This cautious, stepwise approach helps reduce bone marrow and liver toxicity but also delays benefit from the drug.
Studies have shown that giving higher doses of 6-MP early can hasten the benefit of 6-MP without increasing the toxicity in most patients, but some patients do develop severe bone marrow toxicity. Scientists now believe that an individual"s vulnerability to 6-MP toxicity is genetically inherited. Blood tests can be performed to identify those individuals with increased vulnerability to 6-MP toxicity. Blood tests also can be performed to measure the levels of certain by-products of 6-MP. The levels of these by-products in the blood help doctors more quickly determine whether the dose of 6-MP is right for the patient.
TPMT genetics and safety of azathioprine and 6-MP
Azathioprine is converted into 6-MP in the body and 6-MP then is partially converted in the body into inactive and non-toxic chemicals by an enzyme called thiopurine methyltransferase (TPMT). These chemicals then are eliminated from the body. The activity of TPMT enzyme (the ability of the enzyme to convert 6-MP into inactive and non-toxic chemicals) is genetically determined, and approximately 10% of the population in the Untied States has a reduced or absent TPMT activity. In this 10% of patients, 6-MP accumulates and is converted into chemicals that are toxic to the bone marrow where blood cells are produced. Thus, when given normal doses of azathioprine or 6-MP, these patients with reduced or absent TPMT activities can develop seriously low white blood cell counts for prolonged periods of time, exposing them to serious life-threatening infections.
Doctors now can perform genetic testing for TPMT before starting azathioprine or 6-MP. Patients found to have genes associated with reduced or absent TPMT activity are treated with alternative medications or are prescribed substantially lower than normal doses of 6-MP or Azathioprine.
A word of caution is in order, however. Having normal TPMT genes is no guarantee against azathioprine or 6-MP toxicity. Rarely, a patient with normal TPMT genes can develop severe toxicity in the bone marrow and a low white blood cell count even with normal doses of 6-MP or azathioprine. Therefore, all patients taking 6-MP or azathioprine (regardless of TPMT genetics) have to be closely monitored by a doctor who will order periodic blood counts for as long as the medication is taken.
Another cautionary note; allopurinol (Zyloprim), used in treating high blood uric acids levels, can induce bone marrow toxicity when used together with azathioprine or 6-MP. Zyloprim used together with azathioprine or 6-MP has similar effect as having reduced TPMT activity, causing increased accumulation of the 6-MP metabolite that is toxic to the bone marrow.
6-MP metabolite levels
In addition to monitoring blood cell counts and liver tests, doctors also may measure blood levels of the chemicals that are formed from 6-MP (6-MP metabolites), which can be helpful in several situations such as:
1. If a patient"s disease is not responding to standard doses of 6-MP or azathioprine and his/her 6-MP blood metabolite levels are low, doctors may increase the 6-MP or azathioprine dose.
2. If a patient"s disease is not responding to treatment and his/her 6-MP blood metabolite levels are zero, he/she is not taking his/her medication. The lack of response in this case is due to patient non-compliance.
Duration of treatment with azathioprine and 6-MP
Patients have been maintained on 6-MP or azathioprine for years without important long-term side effects. Patients on long-term azathioprine or 6-MP, however, should be closely monitored by their doctors. There are data suggesting that patients on long-term maintenance fare better than those who stop these medications. Thus, those who stop azathioprine or 6-MP are more likely to experience recurrence of their disease and are more likely to need corticosteroids or undergo surgery
