Immunosuppressants

Question 1

Calcinuerin Inhibitor Meds:

Answer 1

Cyclosporine (modified + non-modified), Tacrolimus, Sirolimus

Question 3

Tacrolimus

Answer 3

Inhibits IL-2 -> decr T cell activation

Prevent & TREAT transplant rejection

Question 4

Sirolimus

Answer 4

Inhibits IL-2 -> decr T cell activation
Prevent transplant rejection
Antifungal, antitumor

Question 5

Nursing Implications for CALCINEURIN INHIBITORS

Answer 5

Avoid grapefruit

Levels increased w high fat meals

Question 6

Antimetabolite meds:

Answer 6

Azathioprine, Mycophenolate

Question 7

Azathioprine

Answer 7

Antagonizes purine metabolism -> suppresses T cell immunity & alters antibody formation
Prevents transplant rejection
Treats RA
BLACK BOX: may INCREASE risk for malignancy
AE: lymphoma, N/V

Question 8

Mycophenolate

Answer 8

Inhibits enzyme involved in purine metabolism -> suppression of T & B cell proliferation
Prevents transplant rejection
PREGNANCY CATEGORY D: malformations, abortions
CAN CAUSE HYPERGLYCEMIA, edema, HPN, HTN, tachycardia, pain, h/a, hyperlipidemia, electrolyte disturbances

Question 9

Nursing Implications for Immunosuppresants

Answer 9

High risk for opportunistic infections
May give prophylactic anti-fungal meds
Monitor WBC count
Give WITH food

Question 10

Cyclosporine

Answer 10

Inhibits IL-2 -> decr T-cell activation
NARROW therapeutic range
prevent & TREAT transplant rejection
MODIFIED VERSION can treat RA and psoriasis
Black Box: renal impairment, liver injury, SZ, encephalopathy, skin cancer