ABSITE - transplant Flashcards
mechanism of cyclosporine
binds to cyclophilin A
inhibits calcineurin and IL-2 synthesis
mechanism of tacrolimus
binds to FK-506BP
inhibits calcineurin and IL-2 synthesis
mechanism of mycophenolate mofetil
antimetabolite
inhibits IMP dehydrogenase
inhibits the enzyme necessary for purine synthesis
mechanism of sirolimus
macrolide antibiotic
binds mTOR
blocks IL-2 transduction
mechanism of corticosteroids
inhibit IL-2 production
redistribute lymphocytes
block vasodilator production
mechanism of azathioprine
converted to 6-mercaptopurine
anti-purine metabolite
interferes with DNA and RNA synthesis
blocks proliferation
adverse effects of cyclosporine
nephrotoxicity hypertension hyperlipidemia hirsutism neurotoxicity (seizures, tremor) hepatotoxicity hyperglycemia gingival hyperplasia
adverse effects of tacrolimus
neurotoxicity (seizure, coma) nephrotoxicity hypertension GI toxicity (nausea, diarrhea) hyperglycemia
adverse effects of mycophenolate mofetil
leukopenia
thrombocytopenia
gastritis
GI toxicity
adverse effects of sirolimus
thrombocytopenia neutropenia hyperlipidemia vasculitis NOT nephrotoxic
adverse effects of steroids
Cushingoid state glucose intolerance osteoporosis cataracts myopathy weight gain
adverse effects of azathioprine
bone marrow suppression pancreatitis thrombocytopenia neutropenia anemia liver dysfunction GI upset
clinical use of cyclosporine
maintenance
clinical use of tacrolimus
maintenance
improved patient and graft survival (liver)
clinical use of mycophenolate mofetil
maintenance
primary and rescue therapy (kidney)
may replace azathioprine
clinical use of sirolimus
maintenance
may allow early withdrawal of steroids and decreased calcineurin doses
clinical use of steroids
induction
maintenance
treatment of acute rejection
clinical use of azathioprine
maintenance
mechanism of basiliximab/daclizumab
monoclonal antibody
binds CD-25 (IL-2 receptor)
blocks IL-2 induced T-cell activation
mechanism of rituximab
binds CD20 on B-cells
blocks B-cell activation
mechanism of ATGAM
polyclonal horse antithymocyte immunoglobulin
mechanism of thymoglobulin
polyclonal rabbit antithymocyte immunoglobulin
cytolytic- complement dependent opsonization of T cells
mechanism of OKT-3
monoclonal murine antibody
binds CD3 on T-cell
mechanism of abatacept (Orencia)
fusion of CTLA4 and Fc domain of IgG binds CD80/86 on APC
blocks T-cell activation
mechanism of alemtuzumab
humanized rat IgG binds CD-52 on lymphocytes, eosinophils, macrophages
targets them for destruction
adverse effects of ATGAM
thrombocytopenia
leukopenia
serum sickness
adverse effects of thymoglobulin
leukopenia PTLD cytokine release syndrome headache fevers/chills
adverse effects of OKT-3
pulmonary edema
encephalopathy
aseptic meningitis
nephrotoxicity
adverse effects of abatacept
malignancy
increased risk of infections
adverse effects of alemtuzumab
arthralgia
leukopenia
autoimmune disorders
fevers/chills
adverse effects of basiliximab/daclizumab
noncardiogenic pulmonary edema
adverse effects of rituximab
tumor-lysis syndrome
hypotension
flushing
fever
clinical use of OKT-3
induction
treatment of acute rejection
clinical use of ATGAM
induction
treatment of acute rejection
clinical use of thymoglobulin
induction
treatment of acute rejection
clinical use of alemtuzumab
induction
treatment of acute rejection
clinical use of abatacept
induction
treatment of acute rejection
clinical use of basiliximab/daclizumab
induction
treatment of acute rejection
medications that potentiate nephrotoxicity of cyclosporine
acyclovir
ganciclovir
aminoglycosides
NSAIDs
medications that potentiate nephrotoxicity of tacrolimus
acyclovir
ganciclovir
aminoglycosides
NSAIDs
medications that decrease blood levels of mycophenolate mofetil
cholestyramine
antacids
medications that potentiate bone marrow suppression of azathioprine
allopurinol
sulfonamides
medications that increase blood levels of cyclosporine
P450 inhibitors
medications that increase blood levels of tacrolimus
P450 inhibitors
medications that decrease blood levels of cyclosporine
P450 inducers
medications that decrease blood levels of tacrolimus
P450 inducers