Transplant Flashcards
What is the most commonly used drug in induction therapy?
What to know about Antithymocyte globulin?
How does basiliximab (simulect) work?
Basiliximab (Simulect), IL-2 receptor antagonist.
Atgam is EQUINE and Thymoglobulin is Rabbit. Watch for infusion related reactions and premedicate to lessen. Reverse rejection by binding to T-lymphocytes and interfering with their functions.
Monoclonal antibody that inhibits IL-2 on the surface of activated T-lymphocytes preventing rejection.
What is maintenance immunosuppression?
What to know about prednisone?
What to know about mycophenolate mofetil and acid?
Calcineurin inhibitor, normally tacrolimus. Antiproliferative agent, Mycophenolate. With or without steroids(normally prednisone).
Stuff.
Mofetil (Cellcept), Acid(myfortic). BBW is increased risk of infection, development of lymphoma and skin malignancies, risk of congenital malformations and spontaneous abortions. are not interchangeable, enteric coated to decrease diarrhea. Cellcept IV is D5W only and take on an empty stomach. Decrease levels of hormonal contraception.
What to know about azathioprine?
What to know about tacrolimus?
What to know about cyclosporine?
genetic deficiency of thiopurine methyltransferase causes increased risk of myelosuppression.
Prograf, inhibiting T-lymphocyte activation. Watch for increased susceptibility to infection, lymphoma. Hypertension, nephrotoxicity, hyperglycemia, neurotoxicity, hyperkalemia, hyperlipidemia, QT prolongation. Trough levels, K and Mg, renal function, LFT’s, BP, blood glucose, lipid profile. IV in a non PVC container, CYP 450 3A4 and P-gp substrate.
Neoral, Gengraf, Sandimmune(non modified). BBW of renal impairment, risk of lymphoma, malignancies, skin cancer, risk of infection, modified has greater bioavailability compared to non modified and they can’t be interchanged. Hypertension, nephropathy, hyperkalemia, hypomagnesemia, hirsutism, gingival hyperplasia, edema, hyperglycemia, neurotoxicity, trough levels, serum electrolytes (K and Mg) renal function, BP, blood glucose, lipid profile. Numerous drug interactions Cyp3A4 and P-gp substrate. Every 12 hours on an empty stomach for best absorption.
What is the mTOR kinase inhibitor?
What to know about Sirolimus (Rapamune)?
What to know about belatacept (Nulojix) and HIV opportunistic infections treatment?
Inhibits T lymphocyte activation and proliferation. Peripheral edema, hypertension, do not use within 30 days of transplant, CYP3A4 substrate. Everolimus (Zortress).
Impaired wound healing, hyperlipidemia, irreversible pneumonitis/bronchitis/ cough (discontinue if this develops), hyperglycemia, trough levels, not bioequivalent, CYP3A4 substrate.
Binds to CD80 and CD86 to block T cell costimulation and production of inflammatory mediators. Increased risk of PTLD, use in EBV seropositive patients only. Treat latent TB infection prior to use. Treatment of opportunistic infections is the same as in HIV.
What vaccines do transplant recipients need?
Live vaccines can NOT be given. Influenza annually, Pneumococcal vaccine (PCV13 first if never received), PPSV23 at least 8 weeks later. Varicella vaccine (vaccinate pre transplant, vaccinate recipients close contacts).
