mycophenolate Flashcards

1
Q

what is it used for

A

transplantation and prophylaxis of rejection

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2
Q

what should you do if reccurent infections develop?

A

Measure serum immunoglobulin

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3
Q

recurrent infections could indicate

A

Hypogammaglobulinaemia

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4
Q

what is hypogamamglobulinaemia

A

reduced serum immunoglobulin (antibody) levels

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5
Q

state 2 things it could cause

A

Hypogammaglobulinaemia or bronchiectasis

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6
Q

what should you consider if persistent respiratory symptoms such as cough and dyspnoea develop.

A

bronchiectasis or pulmonary fibrosis

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7
Q

interaction with rifampicin

A

Rifampicin decreases the concentration of Mycophenolate. Manufacturer advises monitor and adjust dose.

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8
Q

monitoring

A

Monitor full blood count every week for 4 weeks then twice a month for 2 months then every month in the first year (consider interrupting treatment if neutropenia develops).

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9
Q

pt should report signs of bone marrow su ppresion

A

infection or inexplicable bruising or bleeding.

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10
Q

what would infection or inexplicable bruising or bleeding indicate

A

bone marrow suppresion

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11
Q

what to do if pure red cell aplasia occurs

A

Cases of pure red cell aplasia have been reported with mycophenolate mofetil; dose reduction or discontinuation should be considered under specialist supervision.

Pure red cell aplasia (PRCA) is a rare blood disorder where the bone marrow fails to produce red blood cells, leading to severe anemia, while production of other blood cells remains normal.

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12
Q

pregnancy prevention and excluding pregnancy

A

The MHRA advises to exclude pregnancy in females of CBP before treatment—2 pregnancy tests 8–10 days apart are recommended.

Women should use at least 1 method of effective contraception before and during treatment, and for 6 weeks after discontinuation—2 methods of effective contraception are preferred.

Male patients or their female partner should use effective contraception during treatment and for 90 days after discontinuation.

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13
Q

contraception advice for males

A

Male patients or their female partner should use effective contraception during treatment and for 90 days after discontinuation.

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14
Q

why should you advice to avoid exposure to sunlight

A

increased susceptibility to skin cancer (avoid exposure to strong sunlight)

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15
Q

risk of. … (2) when used with other immunosuppressants

A

risk of hypogammaglobulinaemia or bronchiectasis when used in combination with other immunosuppressants

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16
Q

drug class and MOA

A

antimetabolite immunosuppressant

Inhibits inosine monophosphate dehydrogenase (IMPDH), an enzyme that lymphocytes use to make guanosine

It works by weakening the body’s immune system to prevent it from attacking and rejecting transplanted organs or to treat autoimmune diseases

Antimetabolites are incorporated into new nuclear material or combine irreversibly with cellular enzymes, preventing normal cellular division.

17
Q

Interaction with aciclovir, gangciclovir, valaciclovir

A

Mycophenolate is predicted to increase the risk of haematological toxicity when given with Aciclovir. Manufacturer advises monitor.