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416 SOT Flashcards

1
Q

Depleting agents for indication therapy

A

ATGAM
RATG
Alemtuzumab

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2
Q

Non-depleting agent for induction therapy

A

Basiliximab

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3
Q

MOA of antithymocytes (RATG, ATGAM)

A

Action against T and B cells

-apoptosis (release cytokines=premedicate)

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4
Q

RATG (Thymoglobulin) dosing

A

1-1.5 mg/kg given over 4-6hrs (round to nearest 25mg due to vial size)

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5
Q

AE of RATG

A
  • leukopenia (hold therapy when WBC <3000)
  • thrombocytopenia
  • fever, chills, malaise, tachycardia
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6
Q

MOA of Alemtuzumab

A

CD52 antagonist

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7
Q

Alemtuzumab dosing

A

30mg SQ x1 prep

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8
Q

AE Alemtuzumab

A

Fever, chills, arthralgia, hypotension

-SQ decreases hypotension

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9
Q

MOA of Basiliximab

A

IL-2 receptor antagonist- prevents activation of IL-2 receptors

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10
Q

Dosing of Basiliximab

A

20mg IV within 2hrs prior to surgery then 20mg IV 3-4days after

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11
Q

Corticosteroids for induction therapy

A

Methylprednisolone 3mg/kg (or 1GM)

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12
Q

Antimicrobial prophylaxis for liver transplant

A

Unasyn 3g q6h for 24hrs

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13
Q

Antimicrobial prophylaxis for liver/small bowel

A

Zosyn 4.5g q6h for 24hrs

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14
Q

Antimicrobial prophylaxis for kidney OR heart

A

Cefazolin 1-2g q8h for 24hrs

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15
Q

Antimicrobial prophylaxis for kidney/pancreas

A

Cefoxitin 1-2g q8h for 24hrs

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16
Q

VTE prophylaxis

A

Heparin 5000 units SQ q8h OR

Lovenox 40mg SQ QD

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17
Q

Cyclosporine brand names for maintenance therapy

A

Sandimmune
Neoral
DO NOT switch

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18
Q

MOA of cyclosporine

A

Calcineurin inhibitor that inhibits secretion of IL-2

-inhibits T cell activation and proliferation

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19
Q

Tacrolimus brand names for maintenance therapy

A

Prograf

FK

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20
Q

MOA of Tacrolimus

A

Calcineurin inhibitor that inhibits secretion of IL-2

21
Q

AE of calcineurin inhibitors (cyclosporine, tacrolimus)

A

nephrotoxicity
T>C: hyperglycemia, alopecia
C>T: HTN, HLD, hirsutism (TRT w/ Amlodipine, statin)
mycardial hypertrophy, electrolyte imbalance

22
Q

DDI increase calcineurin levels

A 
Azoles 
Diltiazem, verapamil 
Macrolides 
Amiodarone 
Warfarin 
Grapefruit juice
23
Q

DDI decrease calcineurin levels

A 
Phenytoin 
Phenobarbital 
Carbamazepine 
Rifampin 
St. John’s Wart
24
Q

MOA of Sirolimus and Everolimus for maintenance therapy

A

mTOR inhibitor that inhibits response of IL-2

-inhibits T cell proliferation

25
Q

Sirolimus dosing

A

6mg loading dose

2mg QD maintenance

26
Q

AE of Sirolimus and Everolimus

A

myelosuppression
-leukopenia, thrombocytopenia
HLD

27
Q

CI with Sirolimus

A

Voriconazole

Ketoconazole

28
Q

Corticosteroid for maintenance therapy

A

Methylprednisolone 0.5-2mg/kg q6h tapered over next few days then transition to Prednisone 5-20mg QD

29
Q

AE of corticosteroids

A

Hyperglycemia, HTN, altered mood, osteoporosis, glucose intolerance, HLD

30
Q

Mycophenolate (MMF) brand names for maintenance therapy

A

Mycophenolate mofetil: Cellcept

Mycophenolate sodium: Myfortic

31
Q

MOA of mycophenolate

A

Inhibitor of IMPDH (inhibits purine synthesis)

32
Q

DDI with MMF

A

Acyclovir
Probenecid
Bile acid resins
Al or Mg antacids (Maalox)

33
Q

AE of MMF

A

myelosuppression
PML
N/V/D
Teratogenic

34
Q

MOA of Azathioprine for maintenance therapy

A

Inhibits cell division

Prohibits lymphoid cell production

35
Q

BBW on Azathioprine

A

Increased risk of neoplasia has mutagenic potential and hematologic toxicity

36
Q

DDI with Azathioprine

A

Allopurinol

37
Q

AE of Azathioprine

A

myelosuppression

Alopecia, photosensitivity

38
Q

MOA of Belatacept for maintenance therapy

A

Inhibits CD80-CD86 receptor

39
Q

AE of Belatacept

A

N/V, anemia, peripheral edema

40
Q

CMV prophylaxis

Especially +/-

A

Valganciclovir 450mg QD

41
Q

PJP prophylaxis

A

Bactrim low dose

BID on two days per week

42
Q

BK virus treatment

43
Q

Fungal infection treatment

A

Fluconazole

Voriconazole w/ heart/lung (cover aspergillus)

44
Q

Cause HTN

A

Calcineurin inhibitors
Corticosteroids
Impaired kidney graft function

45
Q

Treat HTN

A

Amlodipine (CCB)

46
Q

Cause HLD

A

Calcineurin inhibitors
Corticosteroids
Sirolimus

47
Q

Treat HLD

A

Rosuvastatin (statin)

48
Q

Increased risk of DM

A
  • AA or Hispanic
  • age >40
  • DM pretransplant
  • family hx
  • obesity
49
Q

Increase risk of malignancies

A

> 5yrs post transplant
-skin cancers
PTLD (trt w/Rituximab)

Pharmacy Drugs (37 decks)

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