NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

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What is a major warning for patients taking Azathioprine (Azasan, Imuran)?

Risk of anaphylaxis
Increased risk of myelosuppression in patients with TPMT deficiency
Increased risk of hypertension
Risk of neurotoxicity

The correct answer is: Increased risk of myelosuppression in patients with TPMT deficiency

Azathioprine is commonly used in immunosuppressive therapy to prevent organ rejection after a transplant or to treat certain autoimmune conditions. One major warning associated with azathioprine is the increased risk of myelosuppression, especially in patients who have a deficiency in thiopurine methyltransferase (TPMT) enzyme. TPMT deficiency can lead to excessive bone marrow suppression, resulting in dangerously low levels of blood cells. Monitoring TPMT levels and adjusting the dosage of azathioprine accordingly can help mitigate this risk. Therefore, option B is the correct answer. Anaphylaxis is not a major warning for azathioprine use, although allergic reactions can occur. Azathioprine is not typically associated with an increased risk of hypertension or neurotoxicity.