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Therapeutic Drugs > Transplant Rejection > Flashcards

Transplant Rejection Flashcards

1
Q

Alemtuzumab

A 
Lymphocyte depleting agent
Induction agent 
Mechanism:
- antibody to CD52
Side effects:
- minimal infusion side effects
- infxn risk - need prophylaxis
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2
Q

ATG anti-thymocyte globulin

A 
Lymphocyte depleting agent
Induction agent
Ab against human thymus tissue
Side effects:
- infusion related - tachy, hypotension, flushing, pulm edema
- thrombocytopenia
- leukopenia
- infxn risk - anti-microbial and anti-viral prophylaxis
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3
Q

Basiliximab

A 
Non-lymphcyte depleting agent
Induction agent
Mechanism:
- Blocks IL-2 R (CD25)
Long half-life
Side effects:
- minimal acute toxicity
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4
Q

Tacrolimus

A 
Calcineurin inhbitor
Maintenance therapy
Side effects:
- hyperK
- hypoMg
- hypophosph
- nephrotoxic 
- thrombotic microangiopathy
Tacro specific SE:
- new onset diabetes
- alopecia
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5
Q

Cyclosporine

A 
Calcineurin inhibitor
Maintenance therapy
Side effects:
- hyperK
- hypoMg
- hypophosph 
- nephrotoxic 
- thrombotic microangiopathy
CSA specific SE:
- hirsutism
- gingival hyperplasia
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6
Q

Azathioprine

A 
Antimetabolite agent
- blocks cell cycle
- metabolized to 6MP
- antagonizes purine metabolism, inhibits DNA and RNA synth
Side effects:
- myelotoxicity - leukopenia
- thrombocytopenia
- malignancy risk - skin cancer - sensitizes to UV radiation
Don't give with allopurinol
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7
Q

Mycophenolate mofetil

A

Antimetabolite agent
- blocks cell cycle: inhibits inosine monophosphate dehydrogenase
- block de novo purine biosynthesis
- but does not block salvage pathway of purine biosynth
Side effects:
- neutropenia/leukopenia
- contraindicated in pregnancy

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8
Q

Corticosteroids

A 
Mechanism:
- induces IkB which binds to NF-kB, prevents it from getting into the nucleus and activating cytokine transcription
Uses:
- induction, maintenance, and rx of acute rejection
Side effects:
- cataracts
- osteoporosis
- avascular necrosis of hip
- acne
- cushing's
- growth retardation
- DM
- HTN
- skin thinning
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9
Q

Sirolimus

A 
mTOR inhibitor
Side effects:
- proteinuria - edema
- hyperlipidemia (hypercholesterolemia)
- delayed wound healing
- lymphoceles
- thrombocytopenia
- pneumonitis
- oral ulcers
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10
Q

Everolimus

A

mTOR inhibitor

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11
Q

Belatacept

A

Blocks B7 on APCs
- don’t get CD28 mediated T cell co-stim
Use:
- maintenance

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12
Q

CYP3A4 inducers

A 
St. John's Wort
Rifampin
Phenytoin
Phenobarbital
INH
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13
Q

CYP3A4 inhibitors

A 
Abx
- erythromycin
- clarithromycin
CCBs - non-dihydropyridines
- verapamil
- diltiazem
Antifungal azoles
- ketoconazole
- itraconazole
- fluconazole
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Therapeutic Drugs (7 decks)

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