Transplant Drugs

Question 1

Cyclosporine Extra

Answer 1

increase concentration: cyp inhibitors
decrease concentration: cyp inducers ( st. Johns wort)
INCREASE STATIN CONC. OATP
SIROLIMUS - need to take 4hrs after to avoid interaction
SIGNAL 1 BLOCKER

Question 2

Tacrolimus Extra

Answer 2

same as cyclo for the most part
EXCEPT: gene dependent, Alopecia

Question 3

Sirolimus

Answer 3

MOA: blocks mTOR1 that blocks IL-2 Response ( not message) NOTE: chronic inhibits mTOR2
AE: delayed healing, mouth ulceration, THROMBOCTOPENIA, leukopenia, dyslipidemia, proteinuria
need to adjust dose 5-7 days of last dose

Question 4

Everolimus

Answer 4

MOA: blocks mTOR2 (inhibit IL-2 response)
Notes: shorter HL, even more cyclo blocking
AD: delayed healing, leukopenia, hyperlipidemia, proteinuria

Question 5

Azathioprine

Answer 5

MOA: block purine synthesis to block B and T cell pro-life
Notes: Genetics (Low TPMT need reduction or different drug)
MONITORING: WBC, Hgb, Hot, Put
AD: Bone marrow, myopathy, ALOPECIA, Pancreatitis, Hepatitis

Question 6

Mycophenolate mofetil

Answer 6

MOA: blocks IMPDH to stop Guanosine synthesis (specific to lymphocytes)

Notes: EC can help with GI side effects

Use: maintenance therapy only

AD: GASTROINTESTINAL (dose limiting), N/V, Diarrhea, ab pain, GI hemorrhage, Neutropenia, Anemia

DDI: Antacids, Cholestyramine

Question 7

Basilixiamb

Answer 7

MOA: IL-2 receptor antagonist

Question 8

Antithymocte Globulin

Answer 8

MOA: rabbit anitbody - delept T cells
AD: Cytokine syndrome, Bone marrow, increaced CMV, malignaices