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ABSITE > ABSITE - transplant > Flashcards

ABSITE - transplant Flashcards

1
Q

mechanism of cyclosporine

A

binds to cyclophilin A

inhibits calcineurin and IL-2 synthesis

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2
Q

mechanism of tacrolimus

A

binds to FK-506BP

inhibits calcineurin and IL-2 synthesis

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3
Q

mechanism of mycophenolate mofetil

A

antimetabolite
inhibits IMP dehydrogenase
inhibits the enzyme necessary for purine synthesis

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4
Q

mechanism of sirolimus

A

macrolide antibiotic
binds mTOR
blocks IL-2 transduction

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5
Q

mechanism of corticosteroids

A

inhibit IL-2 production
redistribute lymphocytes
block vasodilator production

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6
Q

mechanism of azathioprine

A

converted to 6-mercaptopurine
anti-purine metabolite
interferes with DNA and RNA synthesis
blocks proliferation

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7
Q

adverse effects of cyclosporine

A 
nephrotoxicity
hypertension
hyperlipidemia
hirsutism
neurotoxicity (seizures, tremor)
hepatotoxicity
hyperglycemia
gingival hyperplasia
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8
Q

adverse effects of tacrolimus

A 
neurotoxicity (seizure, coma)
nephrotoxicity
hypertension
GI toxicity (nausea, diarrhea)
hyperglycemia
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9
Q

adverse effects of mycophenolate mofetil

A

leukopenia
thrombocytopenia
gastritis
GI toxicity

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10
Q

adverse effects of sirolimus

A 
thrombocytopenia
neutropenia
hyperlipidemia
vasculitis
NOT nephrotoxic
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11
Q

adverse effects of steroids

A 
Cushingoid state
glucose intolerance
osteoporosis
cataracts
myopathy
weight gain
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12
Q

adverse effects of azathioprine

A 
bone marrow suppression
pancreatitis
thrombocytopenia
neutropenia
anemia
liver dysfunction
GI upset
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13
Q

clinical use of cyclosporine

A

maintenance

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14
Q

clinical use of tacrolimus

A

maintenance

improved patient and graft survival (liver)

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15
Q

clinical use of mycophenolate mofetil

A

maintenance
primary and rescue therapy (kidney)
may replace azathioprine

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16
Q

clinical use of sirolimus

A

maintenance

may allow early withdrawal of steroids and decreased calcineurin doses

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17
Q

clinical use of steroids

A

induction
maintenance
treatment of acute rejection

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18
Q

clinical use of azathioprine

A

maintenance

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19
Q

mechanism of basiliximab/daclizumab

A

monoclonal antibody
binds CD-25 (IL-2 receptor)
blocks IL-2 induced T-cell activation

20
Q

mechanism of rituximab

A

binds CD20 on B-cells

blocks B-cell activation

21
Q

mechanism of ATGAM

A

polyclonal horse antithymocyte immunoglobulin

22
Q

mechanism of thymoglobulin

A

polyclonal rabbit antithymocyte immunoglobulin

cytolytic- complement dependent opsonization of T cells

23
Q

mechanism of OKT-3

A

monoclonal murine antibody

binds CD3 on T-cell

24
Q

mechanism of abatacept (Orencia)

A

fusion of CTLA4 and Fc domain of IgG binds CD80/86 on APC

blocks T-cell activation

25
Q

mechanism of alemtuzumab

A

humanized rat IgG binds CD-52 on lymphocytes, eosinophils, macrophages
targets them for destruction

26
Q

adverse effects of ATGAM

A

thrombocytopenia
leukopenia
serum sickness

27
Q

adverse effects of thymoglobulin

A 
leukopenia
PTLD
cytokine release syndrome
headache
fevers/chills
28
Q

adverse effects of OKT-3

A

pulmonary edema
encephalopathy
aseptic meningitis
nephrotoxicity

29
Q

adverse effects of abatacept

A

malignancy

increased risk of infections

30
Q

adverse effects of alemtuzumab

A

arthralgia
leukopenia
autoimmune disorders
fevers/chills

31
Q

adverse effects of basiliximab/daclizumab

A

noncardiogenic pulmonary edema

32
Q

adverse effects of rituximab

A

tumor-lysis syndrome
hypotension
flushing
fever

33
Q

clinical use of OKT-3

A

induction

treatment of acute rejection

34
Q

clinical use of ATGAM

A

induction

treatment of acute rejection

35
Q

clinical use of thymoglobulin

A

induction

treatment of acute rejection

36
Q

clinical use of alemtuzumab

A

induction

treatment of acute rejection

37
Q

clinical use of abatacept

A

induction

treatment of acute rejection

38
Q

clinical use of basiliximab/daclizumab

A

induction

treatment of acute rejection

39
Q

medications that potentiate nephrotoxicity of cyclosporine

A

acyclovir
ganciclovir
aminoglycosides
NSAIDs

40
Q

medications that potentiate nephrotoxicity of tacrolimus

A

acyclovir
ganciclovir
aminoglycosides
NSAIDs

41
Q

medications that decrease blood levels of mycophenolate mofetil

A

cholestyramine

antacids

42
Q

medications that potentiate bone marrow suppression of azathioprine

A

allopurinol

sulfonamides

43
Q

medications that increase blood levels of cyclosporine

A

P450 inhibitors

44
Q

medications that increase blood levels of tacrolimus

A

P450 inhibitors

45
Q

medications that decrease blood levels of cyclosporine

A

P450 inducers

46
Q

medications that decrease blood levels of tacrolimus

A

P450 inducers

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