Chapter 33 : immunologic Medications Flashcards

1
Q

What is a transplant?

A

Getting an organ from someone else

Donor or cadivar

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2
Q

What is the issue with organ transplantation?

A

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

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3
Q

What do we do when a patient has an organ transplant?

A

We put them on Immunosuppression drugs for the rest of their lives

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4
Q

Usually how do we start off with immunosuppressant drugs then throughout the time of taking them?

A

Larger amounts and mixed with others

Slower taper off and less mixed

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5
Q

Can transplant recipients receive live vaccines?

A

NO!

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6
Q

Transplant drugs
All increase risk of __
All can cause __
Increased risk of other ___
Avoid ___
Avoid ___

A

Serious infection
Blood dyscrasias
Malignancies ( cancer )
Grapefruit juice
Live vaccines

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7
Q

Why do we tell patients to avoid grapefruit juice?

A

Because it interferes with the metabolism of the drug

So it makes the drug less effective

( immunosuppressants )

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8
Q

Something we do with organ transplants is something called induction therapy, which is?

A

Provides intense Immunosuppression with drugs designed to diminish antigen presentation and T-cell response

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9
Q

Induction therapy
Helps reduce risk of ?

A

Rejection during initial transplant

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10
Q

Induction therapy
One dose ___before transplant
Second dose on ___

A

2 hours
Day 4 after Transplang

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11
Q

What the medication we use for induction of therapy?

A

Basiliximab

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12
Q

What is the function of badiliximab?

A

Prevents body from mounting immune response against transplanted organs

Really a massive immuno suppression drug

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13
Q

What are your side effects of basiliximab? (6)
Think of the basiliximab as near the end
It goes ab CYTO!! Then tell the rest

A

Cytokines releases syndrome
Diabetes mellitus
Capillary leak syndrome
Malignancy
Blood dyscrasis
Anaphylaxis

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14
Q

What is cytokine release syndrome?

Side effects of these syndrome?

A

Infusion reaction caused by release of cytokines from the targets cells into the circulation

Low blood pressure
Nausea
Fever
Chills

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15
Q

If we believe a patient might be at risk of developing cytokine release syndrome what do we do?

A

Premeditate with corticosteroids or acetaminophen plus an antihistamine

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16
Q

Who is at most risk of developing cytokine release syndrome?

A

Asthma
Autoimmune disease
Drug allergies
Previous exposure to the drug

17
Q

Immunosuppressant drugs
Maintenance therapy
- calcineurin inhibitors
- costimulation blockers
- mammalian target of rapamycin inhibitors
- purine antimetabolites
- inosine monophosphate dehydrogenase inhibitors
- corticosteroids

A
18
Q

What is the medication for calcineurin inhibitors? (2)

A

Cyclosporine
Tacrolimus

19
Q

What is the caution for cyclosporine or tacrolimus?

A

No grapefruit juice or grapefruit

20
Q

Many patients say the cyclosporine and tacrolimus taste bad, what can we help with this?

A

Give orange juice or apple juice

21
Q

What are your side effects of calcinueirn inhibitor? (5)

Think of all the toxicity!

A

Neurotoxicity
Nephrotoxity
Hepatotoxicity
Malignancy
Diabetes mellitus

22
Q

What is your corticosteroids medication?

Function? (2)

A

Prednisone

Help with inflammation & suppress immune system

23
Q

What are your corticosteroids side effects?

A

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

24
Q

What time to take prednisone?
Take it with what?
If they have diabetes?
If they have hypertension?
If they cut themselves?

A

Morning
Food to avoid ulcers
Watch out for hyperglycemia
Watch out for higher hypertension
Impaired wound healing

25
Q

What’s vital to inform patients about taking their immunosuppressants?

A

They need to take it everyday because missing a dose may mean rejection