Immunosuppression

Question 1

Side effects of Mycophenolate

Answer 1

Gastrointestinal symptoms
Bone marrow suppression (dose related)
Infection - CMV PML(protective for PJP)
Neoplasia - lymphoma

Question 2

Side effects of tacrolimus and cyclosporine.

Answer 2

Nephrotoxicity - vasoconstriction
Hypertension - vasoconstriction and sodium retention
Neurotoxicity - headache, visual change, seizures
Metabolic - diabetes, hyperlipidaemia, hyperkalaemia
Infections
Malignancy - skin cancers, lymphoproliferative Gastrointestinal - diarrhoea, abdo discomfort

Question 3

What are the contraindications to tacrolimus and cyclosporine?

Answer 3

Concurrent malignancy (not Non-melanoma skin cancer)
Uncontrolled hypertension
Uncontrolled infections
Hypersensitivity

Question 4

Side effects of azathioprine?

Answer 4

Gastrointestinal - nausea and vomiting 
Bone marrow suppression - leukopenia
Infection - bacterial and viral 
Malignancy - skin, lymphoproliferative
Hepatitis and pancreatitis

Question 5

Side effects of mTOR inhibitors?

Answer 5

Increased mortality driven by infection and cardiovascular events

Bone marrow suppression
Thrombotic microangiopathy
Metabolic - hyperlipidaemia and diabetes
Gastrointestinal - constipation and diarrhoea
Respiratory - interstitial pneumonitis
Nephrotoxicity and proteinuria
Post transplant lymphoproliferative disorder
Teratogenicity
Infection - increased CMV infection

Protective for skin scc

Question 6

Tenofovir Alafenamide mechanism and precautions/contraindications

Answer 6

Viral polymerase inhibition

Hepatitis b reactivation after cessation
Renal impairment
Hepatic injury

Question 7

Tenofovir DF mechanism and precautions/contraindications

Answer 7

NRTI

Osteoporosis
Renal toxicity
Hepatitis B flare when ceased