transplant drugs Flashcards

1
Q

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

A

infection and malignancy

live vaccines

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2
Q

transplant drugs are ___

A

immunosupressants

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3
Q

cyclosporine and tacrolimus are ___

A

nephrotoxic

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4
Q

induction therapy for transplant

A

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

it is always IV and includes steroids, thymoglobulin or basiliximab

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5
Q

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

A

triple therapy
calcineurin inhibitor
antimetabolite

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6
Q

what are the calcineurin inhibitors

A

tacrolimus and cyclosporine

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7
Q

brand names for tacrolimus

A

prograf, astagraf XL, Envarsus XR

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8
Q

brand names for cyclosporine

A

gengraf, neoral, sandimmune

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9
Q

what are the antimetabolites

A

mycophenolate, azathioprine

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10
Q

mtor inhbitors

A

sirolimus, everolimus

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11
Q

brand name for mycophenolate

A

cellcept

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12
Q

brand name for azathioprine

A

imuran

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13
Q

brand name for sirolimus

A

rapamune

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14
Q

transplant drugs that are 3a4 substrates

A

tacrolimus, cyclosporine, sirolimus

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15
Q

protopic is what

A

topical formulation of tacrolimus for atopic dermatitis

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16
Q

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

A

without food empty stomach

alcohol

17
Q

for IV tacrolimus what container type

A

glass/ non pvc (polyolefin is fine)

18
Q

tacrolimus increases risk of

A

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

19
Q

must monitor therapeutic levels of what two transplant drugs

A

tacrolimus and cyclosporine

20
Q

tacrolimus SE

A
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)
21
Q

cyclosporine for dry eyes brand names

A

cequa, restasis

22
Q

mix cyclosporine in ___

A

glass use non pvc bags

23
Q

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

A

nephrotoxicity

hirstuism + gingivial hyperplasia

24
Q

transplant drug that you cannot use in pregnancy

A

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

25
Q

azathioprine (imuran) major drug interation with two drugs

A

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

26
Q

sirolimus (rapamune) is indicated for ___ transplant
not used in liver or lung transplant

should also be taken __ hours after cyclosporine

A

renal

4 hours after cyclosporine

27
Q

everolimus is used in __ cancer

A

breast

28
Q

belatacept, thymoglobulin, basiliximab used IV in the

A

hospital

29
Q

you must premedicate with what transplant drug

A

thymoglobulin

30
Q

hazardous agents glove and gown protocol

A

double glove and change them every 30 minutes
gowns should be worn no longer than 3 hours

prepare only in a class II cabinent