Immunosuppressant Drugs

Question 1

Immunosuppressant Drugs - General Info

Answer 1

MOA:
Selectively suppress certain T lymphocyte cell lines

Indications:
Primarily for prevention of organ rejection

Contraindications:
Drug allergy, renal or hepatic failure, HTN, and concurrent radiation therapy

Adverse Effects:
Table 48-2, increased risk for infection

Interactions:
Table 48-3, grapefruit, bananas and tomatoes, high fat foods

Nursing Considerations:

• with missed dose must call Dr. immediately
• need frequent labs
• avoid sick ppl and wash hands!
• take rx as prescribed - exact time with same food (no foods that are contraindicated)
• don’t stop rx abruptly
• have very low therapeutic indexes

Question 2

Key Drugs

Answer 2

Azathioprine

Cyclosporine

Muromonab-CD3

Mycophenolate mofetil

Sirolimus and Tacrolimus

Question 3

Azathioprine

Answer 3

• used with other immunosuppress drugs
• interacts with allopurinol which decrease metabolism in body so there’s bone marrow suppression
• AEs: leukopenia, thrombocytopenia, hepatotoxicity
• NCs: watch liver enzymes!

Question 4

Cyclosporine

Answer 4

• presents organ rejection
• can be sued for psoriasis, arthritis and IBS
• AEs: can cause HTN 50% of the time and Neurotoxicity in 20%, which manifests as tremors, also nephrotoxicity

Question 5

Muromonab-CD3

Answer 5

• treats ACUTE organ rejection
• can reverse rejection
• AEs: fever, chills, tremors, GI signs, fluid retention
• NC: monitor for electrolytes and kidney function

Question 6

Mycophenolate mofetil

Answer 6

• NCs: don’t give with antacids or iron and watch birth control
• AEs: causes HTN too, but not too bad, causes taco and hypergly and low WBC and low platelets

Question 7

Tarcolimus and Sirolimus

Answer 7

• AEs: agitation, confusion, anxiety, hallucinations, albuminuria, acute renal failure
• NCs: watch renal function, take Siro and Tarco 4 hours after cyclosporines