transplant drugs Flashcards
all transplant drugs increase the risk of __ and __ and you shouldnt give them with ___ vaccines
infection and malignancy
live vaccines
transplant drugs are ___
immunosupressants
cyclosporine and tacrolimus are ___
nephrotoxic
induction therapy for transplant
given at the time of transplant to decrease the risk of rejection
it is always IV and includes steroids, thymoglobulin or basiliximab
after transplant you start __ therapy which consists of ___, ____, + and steroid
triple therapy
calcineurin inhibitor
antimetabolite
what are the calcineurin inhibitors
tacrolimus and cyclosporine
brand names for tacrolimus
prograf, astagraf XL, Envarsus XR
brand names for cyclosporine
gengraf, neoral, sandimmune
what are the antimetabolites
mycophenolate, azathioprine
mtor inhbitors
sirolimus, everolimus
brand name for mycophenolate
cellcept
brand name for azathioprine
imuran
brand name for sirolimus
rapamune
transplant drugs that are 3a4 substrates
tacrolimus, cyclosporine, sirolimus
protopic is what
topical formulation of tacrolimus for atopic dermatitis
ER formulations of tacrolimus take with or without food and avoid what
without food empty stomach
alcohol
for IV tacrolimus what container type
glass/ non pvc (polyolefin is fine)
tacrolimus increases risk of
infections and risk of malignancy
its also nephrotoxic
increases BP
can cause hyperkalemia, hyperuricemia
must monitor therapeutic levels of what two transplant drugs
tacrolimus and cyclosporine
tacrolimus SE
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)
cyclosporine for dry eyes brand names
cequa, restasis
mix cyclosporine in ___
glass use non pvc bags
cyclosporine has boxed warning for ___ and two specific SE that make it different from tacrolimus
nephrotoxicity
hirstuism + gingivial hyperplasia
transplant drug that you cannot use in pregnancy
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
azathioprine (imuran) major drug interation with two drugs
allopurinol and feboxustat
(xanathane oxidase inhibitors)
if taking these reduce azathioprine dose by 50-75%)
sirolimus (rapamune) is indicated for ___ transplant
not used in liver or lung transplant
should also be taken __ hours after cyclosporine
renal
4 hours after cyclosporine
everolimus is used in __ cancer
breast
belatacept, thymoglobulin, basiliximab used IV in the
hospital
you must premedicate with what transplant drug
thymoglobulin
hazardous agents glove and gown protocol
double glove and change them every 30 minutes
gowns should be worn no longer than 3 hours
prepare only in a class II cabinent
