416 SOT Flashcards

(49 cards)

1
Q

Depleting agents for indication therapy

A

ATGAM
RATG
Alemtuzumab

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2
Q

Non-depleting agent for induction therapy

A

Basiliximab

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3
Q

MOA of antithymocytes (RATG, ATGAM)

A

Action against T and B cells

-apoptosis (release cytokines=premedicate)

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4
Q

RATG (Thymoglobulin) dosing

A

1-1.5 mg/kg given over 4-6hrs (round to nearest 25mg due to vial size)

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5
Q

AE of RATG

A
  • leukopenia (hold therapy when WBC <3000)
  • thrombocytopenia
  • fever, chills, malaise, tachycardia
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6
Q

MOA of Alemtuzumab

A

CD52 antagonist

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7
Q

Alemtuzumab dosing

A

30mg SQ x1 prep

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8
Q

AE Alemtuzumab

A

Fever, chills, arthralgia, hypotension

-SQ decreases hypotension

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9
Q

MOA of Basiliximab

A

IL-2 receptor antagonist- prevents activation of IL-2 receptors

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10
Q

Dosing of Basiliximab

A

20mg IV within 2hrs prior to surgery then 20mg IV 3-4days after

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11
Q

Corticosteroids for induction therapy

A

Methylprednisolone 3mg/kg (or 1GM)

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12
Q

Antimicrobial prophylaxis for liver transplant

A

Unasyn 3g q6h for 24hrs

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13
Q

Antimicrobial prophylaxis for liver/small bowel

A

Zosyn 4.5g q6h for 24hrs

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14
Q

Antimicrobial prophylaxis for kidney OR heart

A

Cefazolin 1-2g q8h for 24hrs

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15
Q

Antimicrobial prophylaxis for kidney/pancreas

A

Cefoxitin 1-2g q8h for 24hrs

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16
Q

VTE prophylaxis

A

Heparin 5000 units SQ q8h OR

Lovenox 40mg SQ QD

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17
Q

Cyclosporine brand names for maintenance therapy

A

Sandimmune
Neoral
DO NOT switch

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18
Q

MOA of cyclosporine

A

Calcineurin inhibitor that inhibits secretion of IL-2

-inhibits T cell activation and proliferation

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19
Q

Tacrolimus brand names for maintenance therapy

A

Prograf

FK

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20
Q

MOA of Tacrolimus

A

Calcineurin inhibitor that inhibits secretion of IL-2

21
Q

AE of calcineurin inhibitors (cyclosporine, tacrolimus)

A

nephrotoxicity
T>C: hyperglycemia, alopecia
C>T: HTN, HLD, hirsutism (TRT w/ Amlodipine, statin)
mycardial hypertrophy, electrolyte imbalance

22
Q

DDI increase calcineurin levels

A
Azoles 
Diltiazem, verapamil 
Macrolides 
Amiodarone 
Warfarin 
Grapefruit juice
23
Q

DDI decrease calcineurin levels

A
Phenytoin 
Phenobarbital 
Carbamazepine 
Rifampin 
St. John’s Wart
24
Q

MOA of Sirolimus and Everolimus for maintenance therapy

A

mTOR inhibitor that inhibits response of IL-2

-inhibits T cell proliferation

25
Sirolimus dosing
6mg loading dose | 2mg QD maintenance
26
AE of Sirolimus and Everolimus
**myelosuppression** -leukopenia, thrombocytopenia HLD
27
CI with Sirolimus
Voriconazole | Ketoconazole
28
Corticosteroid for maintenance therapy
Methylprednisolone 0.5-2mg/kg q6h tapered over next few days then transition to Prednisone 5-20mg QD
29
AE of corticosteroids
Hyperglycemia, HTN, altered mood, osteoporosis, glucose intolerance, HLD
30
Mycophenolate (MMF) brand names for maintenance therapy
Mycophenolate mofetil: Cellcept | Mycophenolate sodium: Myfortic
31
MOA of mycophenolate
Inhibitor of IMPDH (inhibits purine synthesis)
32
DDI with MMF
Acyclovir Probenecid Bile acid resins Al or Mg antacids (Maalox)
33
AE of MMF
**myelosuppression** PML N/V/D Teratogenic
34
MOA of Azathioprine for maintenance therapy
Inhibits cell division | Prohibits lymphoid cell production
35
BBW on Azathioprine
Increased risk of neoplasia has mutagenic potential and hematologic toxicity
36
DDI with Azathioprine
Allopurinol
37
AE of Azathioprine
**myelosuppression** | Alopecia, photosensitivity
38
MOA of Belatacept for maintenance therapy
Inhibits CD80-CD86 receptor
39
AE of Belatacept
N/V, anemia, peripheral edema
40
CMV prophylaxis | Especially +/-
Valganciclovir 450mg QD
41
PJP prophylaxis
Bactrim low dose | BID on two days per week
42
BK virus treatment
Cidofovir
43
Fungal infection treatment
Fluconazole | Voriconazole w/ heart/lung (cover aspergillus)
44
Cause HTN
Calcineurin inhibitors Corticosteroids Impaired kidney graft function
45
Treat HTN
Amlodipine (CCB)
46
Cause HLD
Calcineurin inhibitors Corticosteroids Sirolimus
47
Treat HLD
Rosuvastatin (statin)
48
Increased risk of DM
- AA or Hispanic - age >40 - DM pretransplant - family hx - obesity
49
Increase risk of malignancies
>5yrs post transplant -skin cancers PTLD (trt w/Rituximab)