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Chest. 2012 Nov;142(5):e1S-e111S. doi: 10.1378/chest.12-1044.

Monitoring of nonsteroidal immunosuppressive drugs in patients with lung disease and lung transplant recipients: American College of Chest Physicians evidence-based clinical practice guidelines.

Author information

1
University of Cincinnati, Cincinnati, OH. Electronic address: bob.Baughman@uc.edu.
2
University of Wisconsin School of Medicine and Public Health, Madison, WI.
3
University of Central Florida, Orlando, FL.
4
University of Texas Health Sciences, San Antonio, TX.
5
University of Chicago Hospitals, Chicago, IL.
6
University of Michigan Health Systems, Ann Arbor, MI.
7
Cleveland Clinic, Cleveland, OH.
8
American College of Chest Physicians, Northbrook, IL.
9
University of Wisconsin School of Pharmacy, Madison, WI.
10
Medical University of South Carolina, Charleston, SC.
11
Mayo Clinic College of Medicine, Rochester, MN.
12
Drexel University College of Medicine, Philadelphia, PA.
13
University of Minnesota, Minneapolis, MN.

Abstract

OBJECTIVES:

Immunosuppressive pharmacologic agents prescribed to patients with diffuse interstitial and inflammatory lung disease and lung transplant recipients are associated with potential risks for adverse reactions. Strategies for minimizing such risks include administering these drugs according to established, safe protocols; monitoring to detect manifestations of toxicity; and patient education. Hence, an evidence-based guideline for physicians can improve safety and optimize the likelihood of a successful outcome. To maximize the likelihood that these agents will be used safely, the American College of Chest Physicians established a committee to examine the clinical evidence for the administration and monitoring of immunosuppressive drugs (with the exception of corticosteroids) to identify associated toxicities associated with each drug and appropriate protocols for monitoring these agents.

METHODS:

Committee members developed and refined a series of questions about toxicities of immunosuppressives and current approaches to administration and monitoring. A systematic review was carried out by the American College of Chest Physicians. Committee members were supplied with this information and created this evidence-based guideline.

CONCLUSIONS:

It is hoped that these guidelines will improve patient safety when immunosuppressive drugs are given to lung transplant recipients and to patients with diffuse interstitial lung disease.

PMID:
23131960
PMCID:
PMC3610695
DOI:
10.1378/chest.12-1044
[Indexed for MEDLINE]
Free PMC Article

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