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2021 > Immunosuppression side effects > Flashcards

Immunosuppression side effects Flashcards

1
Q

Prednisolone (6)

A
  • Immune suppression
  • Bone
  • Weight
  • Diabetes
  • Skin
  • GI

(CVD)

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2
Q

CNI (5)

A
  • Tremor
  • Mood
  • Hypertension
  • Nephrotoxic (vasoconstriction of afferent ateriole)
  • Neurotoxic
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3
Q

Approach to risk of rejection (5)

A
  • r/v baseline renal function - graft function *compare to present
  • HLA mismatch
  • DSA sensitising events
  • Previous renal biopsies - protocol/past rejection episodes
  • Adherence/absorption problems
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4
Q

Steroids (9)

A
  • Insomnia
  • Mood
  • Altered fat
  • Cataracts
  • Oedema
  • Diabetogenic
  • OP
  • HTN
  • Hchol
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5
Q

mTOR Inhibitor

A
  • Impaired wound healing *if major OT - switch to CNI for OT before changing back to mTOR I
  • Hyperlipidaemia
  • Oedema
  • Proteinuria - d/t podocyte dysfunction
  • Pneumonitis - esp sirolimus
  • Cytopenia
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6
Q

MMF

A
  • Diarrhoea
  • Cytopenia
    *Teratogenic
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7
Q

Azathioprine

A
  • Cytopenia
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8
Q

CNI (10)

A
  • Neurotoxicity
  • Tremor
  • Diabetogenic
  • Cytopenia
  • Nephrotoxic
  • Increase uric acid
  • Hyperlipidaemia
  • HTN
  • Hyperkalaemia - distal RTA - aldosterone R in distal nephron
  • Hypomagnesemia
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9
Q

Tacrolimus (1)

A
  • Alopecia
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10
Q

Cyclosporin (1)

A
  • Gingival hyperplasia
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11
Q

Infection risk - highest in early Tx period when IS is highest

A
  • Any infections - CAP/UTI/Flu
  • Viruses: CMV, EBV, HSV, BK, JC, Varicella
  • Toxo: parasite
  • Candida, PJP, Aspergillus
  • Nocardia
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12
Q

Dapsone

A
  • PJP
  • Toxo
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13
Q

Bactrim

A
  • PJP
  • Nocardia
  • Toxo
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14
Q

Pentamidine

A
  • PJP
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15
Q

Valganciclovir SE

A
  • Leucopenia
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16
Q

Live vaccines

A
  • MMR
  • VZV
  • BCG
  • Yellow fever
17
Q

Malignancy risk increases by 3-5x!

A
  • D/t cellular immunity suppressing cancer cells and viruses
18
Q

Oncogenic viruses (3)

A
  • HPV - Cervical, SCC
  • EBV - PTLD - high mortality - RF: ATGAM
  • HHV 8 - KS
19
Q

Skin cancer - duration and intensity of IS

A
  • SCC - UV light
20
Q

Cancer screening

A
  • Annual skin check by dermatologist
  • Mammogram
  • PAP smear
  • FOBT (C’scope > FOBT)
  • RCC - TS, VHL
  • HCC - if HCV, HBV - 6/12 USS + AFP

*Prev history of malignancy

21
Q

Infection approach (5)

A

1) Vector avoidance
2) Vaccinations
3) Prophylactic antibiotics
4) Appropriate immunosuppression
5) Prompt management of infective episodes - involve GP, early presentation to ED

22
Q

Pregnancy safe IS (4)

A
  • Prednisolone
  • Tacrolimus
  • Cyclosporin
  • Azathioprine
23
Q

Teratogenic (3)

A
  • MMF
  • mtor-I
  • MTx
24
Q

MTx SE (8)

A
  • Lung fibrosis
  • Liver cirrhosis
  • Skin Cx
  • Teratogenic
  • Infection
  • Mouth ulcers
  • Alopecia
  • Pneumonitis

2021 (34 decks)

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