Transplant Drugs Flashcards
1
Q
Prograf
- MOA
- Dosage forms
- Administration instruction
- SEs
- MOnitor
- Conversion IV to PO
Pediatric
Renal/Liver dysfunction - DDIs
A
Tacrolimus
- MOA: inhibits T lymphocyte cell activation
- Dosage forms: IV, 0.5, 1, 5mg cap, topical. Take on EMPTY stomach
SEs
- Increase Cr, blood sugar, K, cholesterol
- Decrease: WBC
- HTN
- Stomach upset, diarrhea
- Hand tremor: go away w/ time
- Hair loss
Monitor:
- Renal, hepatic, glucose, electrolytes, BP
Conversion
- IV to PO: 3x increase going from IV to PO
- Ped: 2x higher dose
- Renal/Liver dysfunction: decrease dose
DDIs: Major 3A4 substrate
- Inhibitors: voriconazole, grape fruit juice
- Inducers: St. John’s Wort
- Take on empty stomach
- Nephrotoxicity drugs
2
Q
CellCept
- MOA
- Dosage forms
- Administration instruction
Separate from: - ADEs
- BBW
- Monitor
- DDIs
A
Mycophenolate mofetil
- MOA: inhibit T and B lymphocytes
- Dosage form: IV, PO cap (PO and susp take on EMPTY stomach), oral suspension
ADES
- Decrease: WBC
- Increase: BP
- GI upset, diarrhea: most common
Monitor
- S/S of infection
- Pregnancy test prior to initiation
- BBW: Incr risk of malformation/abortions
- 2 forms of contraceptive 4 wks prior to therapy, during, and 6 wks after stop therapy
DDIs
- Ca+2: cannot take at the same time. Take 1H b/4 or 2H after.
3
Q
Sandimmune
Neoral
Gengraf
- MOA
- Non-modified
- Dose
- BBW
- DDIs
Sandimmune IV
- Storage
- Stable
A
Cyclosporin
- MOA: Inhibition of production and release of interleukin II and inhibits interleukin II induced activation of resting T-lymphocytes
- Non-Modified: Sandimmune
- Modified: Neoral, Gengraf => can substitute
- Dose: BID
BBW:
- Renal impairment
- Increase risk of lymphomas and other malignancies
DDIs - Major P450 substrate - Nephrotoxicity drugs can enhance ACEI/aminoglycosides/ Vanco/ Ampho B/ Cipro/ NSAIDs Bactrim
Sandimmune IV
- Storage: RT and protect from light
- Stable: 6H in PVC and 24H in excel or glass
4
Q
Sirolimus
Rapamycin
- MOA
- Oral sol’n storage
- Tablet storage
- SEs
- Monitor
- DDIs
A
Rapamune
- MOA: suppresses cytokine mediated T-cell proliferation, halting G1 and S phase of the cell cycle
- Oral sol’n storage: fridge, protect from light
- Tablet storage: RT, protect from light
SEs
- GI
- Decrease: WBC, wound healing
- Increase: cholesterol, LFT
- Mouth/lips ulcers
- Rash
Monitor
- CBC, LFTs, Renal, TC, TG, BP
- Infection
DDIs
- P450 substrate
5
Q
Imuran
- MOA
- IV storage
- Tablet storage
- SEs
- Monitor
A
Azathioprine
- MOA: derivative 6-mercaptopurine; antagonizes purine metabolism. May inhibit DNA, RNA and proteins synthesis
- IV storage: RT, protect from light, stable 24H at RT and 16 days in fridge
- Tablet storage: RT and protect from light
SEs
- Decrease WBC
- GI: stomach upset and dirrhea
Monitor
- CBC, LFT Q3M,
6
Q
Solo-Medrol
- Indication
- SEs
A
methylprednisolone
- Indication: help prevent an immune response against transplants, tx acute rejection
SEs
- Increase BP, BP, cholesterol
- Stomach upset, diarrha
- Wt gain
- Cataracts
- Acne
- Bone lost/night sweat/mood swings
7
Q
Orthoclone OKT3
A
Muromonab CD3
8
Q
Simulect
- Indication
- Dose
A
Basiliximab
- Indication: help prevent acute rejection within the first few weeks after the transplant
- Dose: 1st dose given during transplant and 2nd dose will be given 4 days later. Most pt requires 2 doses
9
Q
Thymoglobulin
- Indication
- Dose
A
Thymoglobulin
- Indication: IV to help prevent acute rejection w/in first few weeks after transplant
- Dose: 4 doses: during transplant and 3 doses after transplants