Chapter 33 : immunologic Medications Flashcards
What is a transplant?
Getting an organ from someone else
Donor or cadivar
What is the issue with organ transplantation?
The body will see this as a foregin body instead of like an actual organ to help us
Which is a good thing to fight an infection but when you’re sick and need this transplant, it’s really bad
What do we do when a patient has an organ transplant?
We put them on Immunosuppression drugs for the rest of their lives
Usually how do we start off with immunosuppressant drugs then throughout the time of taking them?
Larger amounts and mixed with others
Slower taper off and less mixed
Can transplant recipients receive live vaccines?
NO!
Transplant drugs
All increase risk of __
All can cause __
Increased risk of other ___
Avoid ___
Avoid ___
Serious infection
Blood dyscrasias
Malignancies ( cancer )
Grapefruit juice
Live vaccines
Why do we tell patients to avoid grapefruit juice?
Because it interferes with the metabolism of the drug
So it makes the drug less effective
( immunosuppressants )
Something we do with organ transplants is something called induction therapy, which is?
Provides intense Immunosuppression with drugs designed to diminish antigen presentation and T-cell response
Induction therapy
Helps reduce risk of ?
Rejection during initial transplant
Induction therapy
One dose ___before transplant
Second dose on ___
2 hours
Day 4 after Transplang
What the medication we use for induction of therapy?
Basiliximab
What is the function of badiliximab?
Prevents body from mounting immune response against transplanted organs
Really a massive immuno suppression drug
What are your side effects of basiliximab? (6)
Think of the basiliximab as near the end
It goes ab CYTO!! Then tell the rest
Cytokines releases syndrome
Diabetes mellitus
Capillary leak syndrome
Malignancy
Blood dyscrasis
Anaphylaxis
What is cytokine release syndrome?
Side effects of these syndrome?
Infusion reaction caused by release of cytokines from the targets cells into the circulation
Low blood pressure
Nausea
Fever
Chills
If we believe a patient might be at risk of developing cytokine release syndrome what do we do?
Premeditate with corticosteroids or acetaminophen plus an antihistamine
Who is at most risk of developing cytokine release syndrome?
Asthma
Autoimmune disease
Drug allergies
Previous exposure to the drug
Immunosuppressant drugs
Maintenance therapy
- calcineurin inhibitors
- costimulation blockers
- mammalian target of rapamycin inhibitors
- purine antimetabolites
- inosine monophosphate dehydrogenase inhibitors
- corticosteroids
What is the medication for calcineurin inhibitors? (2)
Cyclosporine
Tacrolimus
What is the caution for cyclosporine or tacrolimus?
No grapefruit juice or grapefruit
Many patients say the cyclosporine and tacrolimus taste bad, what can we help with this?
Give orange juice or apple juice
What are your side effects of calcinueirn inhibitor? (5)
Think of all the toxicity!
Neurotoxicity
Nephrotoxity
Hepatotoxicity
Malignancy
Diabetes mellitus
What is your corticosteroids medication?
Function? (2)
Prednisone
Help with inflammation & suppress immune system
What are your corticosteroids side effects?
Sodium retention
Edema
Weight gain
Infection
Hypertension
Hypokalemia
Cataracts
GI distress
GI bleeding
Insomnia
Anxiety
Emotional lability
Depression
Hyperglycemia
Psychosis
Peptic ulcer disease
Impaired wound healing
What time to take prednisone?
Take it with what?
If they have diabetes?
If they have hypertension?
If they cut themselves?
Morning
Food to avoid ulcers
Watch out for hyperglycemia
Watch out for higher hypertension
Impaired wound healing
What’s vital to inform patients about taking their immunosuppressants?
They need to take it everyday because missing a dose may mean rejection
