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My own Naplex > Transplant > Flashcards

Transplant Flashcards

1
Q

Atgam

A

Anthithymocyte Globulin

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2
Q

Thymoglobulin

A

Anthithymocite Globulin

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3
Q

What would be used for high risk induction and can also be used for tx of rejection?

A

Atgam/Thymoglobulin (aka anthithymocite globulin)

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4
Q

What are the side effects of Anthithymocite globulins (atgam and thyroglobulin)

A

infusion reactions, must premedicate with (dihphenhydramine, acetaminophen, and steroids)

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5
Q

What is the MOA of Anthithymocite globulins (atgam and thyroglobulin)

A

Binds to antigens on T-lymphocytes (killer cells) and interferes with their function

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6
Q

What is the MOA of Basiliximab

A

monocolonial antibody that inhibits the IL-2 receptor on the surface of activated T-lymphocyte sprecenting rejection

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7
Q

What is the maintenance therapy for immunosuppression?

A

1) A Calcineurin inhibitor (CNI) - Tacrolimus
2) A antiproliferative agent - mycophenolate
3) With or without steroids

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8
Q

Prednisone side effects

A

fluid retention, stomach upset, emotional instability, insomnia, increased appetite, weight gain, acute rise in blood glucose and blood pressure

long term may cause cushings, impaired wound healing, diabetes, osteoporosis, impaired growth in children

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9
Q

CellCept

A

Mycophenolate Mofetil *only good in D5W

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10
Q

Myfortic

A

Mycophenolic Acid *enteric coated to decrease GI upset

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11
Q

Antiproliferative agents (i.e. Mycophenolate) effects

A

Warnings: increased risk of infection, increased development of malignancies, increased risk of birth defects and abortions, decrease efficacy of birth control

Side effects: Diarrhea, GI upset

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12
Q

Who is at risk for myelosupression

A

genetic deficiency of thiopurine methyltransferase (TPMT)

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13
Q

Prograf

A

Tacrolimus

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14
Q

Tacrolimus boxed warning

A

increased susceptibility to infection and possible lymphoma

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15
Q

Side effects of tacrolimus and monitoring

A

increased BP, K, BG, lipids

nephrotoxic, neurotoxic, QT-prolonging

Monitor: Serium electrolytes (K, Phos, and MG), renal function, LFTs, BP, blood glucose, lipid profile

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16
Q

Non PCD pneumonics

A 
Leach - Lorazepam
Absorbs - Amiodarone
To - Tacrolimus
In - Insulin
Nutrients - Nitroglycerin
17
Q

What is the MIA of everolimus/sirolimus

A

MTOR kinase inhibitor to inhibit T lymphocyte activation and proliferation

18
Q

neograf

A

cyclosporine

19
Q

gengraf

A

cyclosporine

20
Q

side effects of mtor (everolimus, sirolimus)

A

warning - hyperlipidemia *do not use witrhin 30 days of transplant

side effects - peripeheral edema, increased BP

21
Q

sirolimus warnings

A

warnings: impaired would healing, hyperlipidemia, impaired wound healing

22
Q

MOA of belacept

A

binds to CD80 and CD86 to block T cell costimulation and production of inflammatory mediators

23
Q

boxed warning of belacept

A

increased risk of post-transplantlymphoproliferative disorder therefore use in EBV seropositive patients only

must treat latent TB prior to use

24
Q

Major cyp inhibitors

A

PACMAN G - C = cyclospirine

25
Q

Which immunosupressians cause nephrotox

A

tacrolimus and cyclosporing

26
Q

which immunosupressants worsen diabetes

A

tacrolimus, steroids, and cyclosporine

27
Q

which immunosupressants worsen lipid parameters

A

mtor*, steroids, cyclosporine

28
Q

which immunosupressants worsen hypertension

A

steroids, cyclosporine, tacrolimus

29
Q

what causes acute recection

A

T-cell (cellular) or B-cell (humoral or antibody) which can be distinguished via biopsy

30
Q

Vaccins for transplant recipients

A

influenza, pneumonicoccal 8 weeks apart, varicella (if not previously received)

31
Q

how often to take tacrolimus

A

every 12 hourson an empty stomach

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