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Drug-induced depression of immunity in the critically ill 

Drug-induced depression of immunity in the critically ill
Drug-induced depression of immunity in the critically ill

Russell J. McCulloh

and Steven M. Opal

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date: 22 February 2020

Immunosuppressive drugs are among the fastest-growing category of drugs in medicine today, both in terms of new medication development and in terms of use. Glucocorticoids, calcineurin inhibitors, and biological agents, among others, are used in a variety of diseases. . Although often of great benefit to patients, immunosuppressive agents also pose significant long-term risks for opportunistic infection. These drugs can also blunt normal host responses to infection, and patients receiving immunosuppressive medications are at high risk for severe illness, sepsis, and death from opportunistic infections. Knowledge of immunosuppressive agents, their mechanisms of action, effects on the immune system, and commonly-associated infectious complications plays an instrumental role in guiding appropriate diagnostic and treatment plans for immunosuppressed patients. This chapter reviews the most commonly-used immunosuppressive agents today, and provides the reader with the specific effects these medications can have on a patient’s immune system and the potential infectious agents of concern associated with their prolonged use.

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