Immunosuppressant Drugs

Question 1

MOA of Immunosuppressant Drugs

Answer 1

Selectively suppresses certain T lymphocyte cell lines– blocks body’s immune response

Question 2

Indications for Immunosuppressant Drugs

Answer 2

Primarily for prevention of organ rejection. Can also be used for treatment.

Question 3

Nursing Considerations for Immunosuppressant Drugs

Answer 3

increased risk for infection- stay around people who are sick, wash hands frequently. Take drug exactly as prescribed- call physician immediately if you miss a dose. Very narrow therapeutic indexes- will be taking frequent lab draws to make sure drug levels are appropriate. Monitor renal and hepatic function. Take blood pressure regularly because it has the potential to cause hypertension

Question 4

Immunosuppressant Key Drugs

Answer 4

azathioprine
cyclosporine
muromonab-CD3
mycophenolate mofetil
sirolimus and tacrolimus

Question 5

MOA and Indications for Azathioprine

Answer 5

Blocks metabolism of purines, which inhibits the synthesis of T cell DNA and blocks immune response.
Prophylaxis to prevent organ rejection.

Question 6

Nursing Considerations for azathioprine

Answer 6

Can cause leukopenia, thrombocytopenia, and liver toxicity. Monitor drug levels (increases level of allopurinol in body) and watch labs.

Question 7

MOA and Indications for cyclosporine

Answer 7

Inhibits activation of T cells- used to treat organ rejections (also used in arthritis, psoriasis, and IBS).

Question 8

Nursing Considerations for cyclosporine

Answer 8

Can cause hypertension, neurotoxicity (tremors of hands), and hepatotoxicity (monitor drug levels closely). Nephrotoxicity can be dose limiting.

Question 9

MOA and Indications for muromonab-CD3

Answer 9

Binds to CD3 glycoprotein on T-cell receptors. Blocks antigen recognition, which can cause organ rejection to occur. Prevents and TREATS (can reverse) organ rejection

Question 10

Nursing Considerations for muromonab-CD3

Answer 10

Wide variety of adverse effects- fever, chills, nausea, vomiting, diarrhea, tremors. Monitor kidney function and watch for fluid retention

Question 11

MOA and Indications for mycophenolate mofetil

Answer 11

Prevents growth of T cells by inhibiting purine. For prevention and treatment of organ rejection.

Question 12

Nursing Considerations for mycophenolate mofetil

Answer 12

Can cause hypertension (more mild than cyclosporine). Also tachycardia, hyperglycemia, decreased WBC and platelets, increased lipids. Do not give with antacids or iron (decrease absorption). Decreases effectiveness of oral contraceptives

Question 13

MOA and Indications for Sirolimus and Tacrolimus

Answer 13

inhibits T cell activation by binding to intracellular proteins used in combination with other drugs to prevent organ rejection. Sirolimus and Tacrolimus are often given together

Question 14

Nursing Considerations for Sirolimus and Tacrolimus

Answer 14

Can cause agitation, anxiety, confusion. Should watch renal function very closely. Interacts with a lot of different drugs.