transplant drugs

Question 1

all transplant drugs increase the risk of __ and __ and you shouldnt give them with ___ vaccines

Answer 1

infection and malignancy

live vaccines

Question 2

transplant drugs are ___

Answer 2

immunosupressants

Question 3

cyclosporine and tacrolimus are ___

Answer 3

nephrotoxic

Question 4

induction therapy for transplant

Answer 4

given at the time of transplant to decrease the risk of rejection

it is always IV and includes steroids, thymoglobulin or basiliximab

Question 5

after transplant you start __ therapy which consists of ___, ____, + and steroid

Answer 5

triple therapy
calcineurin inhibitor
antimetabolite

Question 6

what are the calcineurin inhibitors

Answer 6

tacrolimus and cyclosporine

Question 7

brand names for tacrolimus

Answer 7

prograf, astagraf XL, Envarsus XR

Question 8

brand names for cyclosporine

Answer 8

gengraf, neoral, sandimmune

Question 9

what are the antimetabolites

Answer 9

mycophenolate, azathioprine

Question 10

mtor inhbitors

Answer 10

sirolimus, everolimus

Question 11

brand name for mycophenolate

Answer 11

cellcept

Question 12

brand name for azathioprine

Answer 12

imuran

Question 13

brand name for sirolimus

Answer 13

rapamune

Question 14

transplant drugs that are 3a4 substrates

Answer 14

tacrolimus, cyclosporine, sirolimus

Question 15

protopic is what

Answer 15

topical formulation of tacrolimus for atopic dermatitis

Question 16

ER formulations of tacrolimus take with or without food and avoid what

Answer 16

without food empty stomach

alcohol

Question 17

for IV tacrolimus what container type

Answer 17

glass/ non pvc (polyolefin is fine)

Question 18

tacrolimus increases risk of

Answer 18

infections and risk of malignancy
its also nephrotoxic
increases BP
can cause hyperkalemia, hyperuricemia

Question 19

must monitor therapeutic levels of what two transplant drugs

Answer 19

tacrolimus and cyclosporine

Question 20

tacrolimus SE

Answer 20

T tremor
A alopecia, acne
C cardiovascular (htn)
R renal (nephrotoxicity)
O oncology (Skin cancer, avoid sun/uv)
L liver (3A4 substrate)
I Infection, Immunosupression, increase K
M Monitor levels, Malignancy
U Uric acid (increase)
S Seizures (neurotoxicity)

Question 21

cyclosporine for dry eyes brand names

Answer 21

cequa, restasis

Question 22

mix cyclosporine in ___

Answer 22

glass use non pvc bags

Question 23

cyclosporine has boxed warning for ___ and two specific SE that make it different from tacrolimus

Answer 23

nephrotoxicity

hirstuism + gingivial hyperplasia

Question 24

transplant drug that you cannot use in pregnancy

Answer 24

mycophenolate!! (cellcept/myfortic)
must have a neg. preg. test within one week prior to initiation of tx

two forms of BC starting 4 weeks prior

Question 25

azathioprine (imuran) major drug interation with two drugs

Answer 25

allopurinol and feboxustat (xanathane oxidase inhibitors) if taking these reduce azathioprine dose by 50-75%)

Question 26

sirolimus (rapamune) is indicated for ___ transplant not used in liver or lung transplant should also be taken __ hours after cyclosporine

Answer 26

renal 4 hours after cyclosporine

Question 27

everolimus is used in __ cancer

Answer 27

breast

Question 28

belatacept, thymoglobulin, basiliximab used IV in the

Answer 28

hospital

Question 29

you must premedicate with what transplant drug

Answer 29

thymoglobulin

Question 30

hazardous agents glove and gown protocol

Answer 30

double glove and change them every 30 minutes gowns should be worn no longer than 3 hours prepare only in a class II cabinent