Side Effects

Question 1

Dose-limiting side effects of antithymocyte globin (atgam, thymoglobin)

Answer 1

Hemolytic effects (leukopenia, thrombocytopenia) are dose limiting

Question 2

What IV medication MUST you premediate to lessen the infusion related reactions?

Answer 2

Antithymocyte Globulin (Atgam, Thymoglobulin) premediate with diphenhydramine, APAP, and steroids

Question 3

Long term side effects of prednisone (Deltasone)

Answer 3

Adrenal suppression/Cushings syndrome
Impaired wound healing
increased BP
diabetes
acne
osteoporosis
impaired growth in children

Question 4

Short term side effects of prednisone (Deltasone)

Answer 4

edema
stomach upset
emotional instability
insomnia
increased appetite
weight gain
acute rise in BG and BP

Question 5

Boxed warning with mycophenolate mofetil (CellCept) and mycophenolate acid (Myfortic)

Answer 5

increased risk of congenital malformation and spontaneous abortions ==== REMS

Question 6

Side effects of mycophenolate motefetil (CellCept)

Answer 6

Diarrhea!!!
GI upset
Hemolytic effects
Electrolyte abnormalities

Question 7

Side effects of mycophenolate acid (Myfortic)

Answer 7

Less diarrhea due to enteric coating
GI upset
Hemolytic effects
Electrolyte abnormalities

Question 8

Side effects of Azathioprine

Answer 8

Warning: TPMT are at INCREASED risk of myleosuppression
SE: myleosuppression, hepatotoxicity, GI upset, increased LFT

Question 9

Side effects of Tacrolimus (Prograf)

Answer 9

More common: Increase BG, Neurotoxicity, NEPHROTOXICITY, alopecia, hemolytic effects, hyperkalemia, QTc prolongation

Less common: hyperlipidemia, hypertension, hypertriglycerides, other electrolyte abnormalities

CYP3A4 substrate

Question 10

Side effects of cyclosporine (Gengraf, Neoral, Sandimmune)

Answer 10

More common: hyperlipidemia, hypertension, hypertriglycerides, nephrotoxicity, hemolytic effects, hirsutism, gingival hyperplasia, hyper K, hypo Mg

Less common: neurotoxicity, diabetes

CYP3A4 inhibitor AND substrate

Question 11

Side effects of Everlimus

Answer 11

NOT recommended in heart transplant
Warning: HLD, impaired wound healing, hemolytic effects
SE: peripheral edema, hypertension, risk of renal and hepatic artery thrombosis (Do NOT use within 30 days of transplant)

CYP3A4 substrate

Question 12

Side effects of Sirolimus

Answer 12

NOT recommended for liver or lung transplant
Warning: HLD, impaired wound healing
SE: irrversible pneumonitis/bronchitis/cough, increased BG, peripheral edema, hypertension

CYP3A4 substrate

Question 13

Liraglutide (Sexenda)

Answer 13

Nausea!!
Warning: pancreatitis, hypoglycemia
Risk of thyroid C cell carcinoma

Question 14

Orlistat (Xenical, Alli)

Answer 14

Warning: liver damage, kidney stones, hypoglycemia
SE: GI fatty stools, fecal urgency

**takes with meals

Question 15

Phentermine (Adipex P) C-IV

Answer 15

CI: CVD (uncontrolled HTN, arrhthmias, HF, CAD), hyperthroidism, glaucoma, history of drug abuse, MAO inhibiotrs within 14 days
SE: tachycardia, agitation, increased BP

Question 16

Naltrexone/Buproprion (Contrave)

Answer 16

CI: chronic opioid uses, uncontrolled HTN, seizure disorders, bulimiai/anorexia, use of MAO inhibitor within 14 days
SE: N/V, constipation, HA,