transplantation pharm Flashcards
compare AEs of cyclosporine vs. tacrolimus
tacrolimus = greater incidence of hyperglycemia, neurotoxicity (tremors)… but lower incidence of HTN, gingival hyperplasia, hirsutism
what DDIs are associated with cyclosporine?
inh. of CYP3A4 metabolism = grapefruit juice, erythromycing, ketoconazole, diltiazem, OCs
induction of CYP3A4 = phenytoin, SJW
statins
Sirolimus
which drugs increase risk of nephrotoxicity while taking cyclosporine?
aminoglycosides
amphotericin B
What are MOA of sirolimus/everolimus?
mTOR inhibitor (blocks signal 3 of t cell activation)
what are DDIs associated with sirolimus/everolimus?
cyclosporine inhibits its metabolism
what AEs are associated with sirolimus and everolimus?
delayed wound healing, BM suppression, inc. risk of infections/malignancies, dyslipidemia
compare half-lives of sirolimus and everolimus
everolimus = shorter!
what is the MOA of azathioprine?
nucleoside synthesis inhibitor; inhibits proliferation and differentiation of T/B cells
What AEs are associated with azathioprine?
BM suppression
pancreatitis
hepatitis
alopecia, myopathy (targets fast growing cells)
what DDI is associated with azathioprine?
allopurinol
what’s the MOA of daclizumab and basiliximab?
IL-2 R antagonists (prevent binding and subsequent cascade of T cell activation) - signal 3
what are AEs associated with daclizumab and basiliximab?
minimal … hypersensitivity rxns
what is the MOA of antithymocyte globulin?
polyclonal antibody causes depletion of circulating T cells
what are AEs associated with anti-thymocyte globulin?
cytokine storm
BM suppression
inc. risk of CMV, malignancies
which drugs are used for maintenance?
cyclosporine, tacrolimus, sirolimus, everolimus, azathioprine
