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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Orthoclone OKT3

A

Muromonab CD3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly