Transplant Medications Flashcards
What are the BBW for tacrolimus (3)?
- Only experienced physician
- Malignancies (lymphoma and skin cancer) and serious infections
- (Astagraf XL) Increased mortality in female liver transplant patients
What are 3 brand names for tacrolimus?
- Prograf
- Hecoria
- Astagraf XL
What class is tacrolimus?
Calcineurin Inhibitor
When should the initial postoperative dose of tacrolimus be for liver and heart? Kidney?
- Liver and heart = No sooner than 6 hours
2. Dose within 24 hours, wait 6 hrs for oliguria (low urine)
What is a concern for IV tacrolimus?
Should only be continued until oral is tolerated.
Anaphylaxis has been reported with IV (it contains a castor oil derivative)
Is tacrolimus removed by dialysis?
Not removed
What organs is the tacrolimus (Astagraf XL) formulation indicated for?
Kidney
What are tacrolimus IV administration pearls?
- Only continuous infusion (over 24 hours)
- Do not use PVC tubing
What is a pH consideration for tacrolimus?
Do not mix with medication solution with a pH>9 (acyclovir or ganciclovir) due to degradation of tacrolimus
What are PO tacrolimus IR administration pearls?
- With or without food (use similar meals times)
- Food decreases bioavailability (be consistent)
- If BID, give 12 hrs apart (if dose different, give larger dose in the morning)
What are PO tacrolimus ER administration pearls?
- On empty stomach 1 hour before or 2 hours after meal (IR is with or without)
- Food decreases bioavailability
