Medications

Question 1

What are side effects of mTOR inhibitors?

What monitoring should be performed?

Answer 1

Hyperlipidaemia.

Leukopaenia

LFT derangement (transaminases).

1/3 develop oral aphthous ulcers.

Monitoring:

FBC, LFT’s, urea and electrolytes.

Drug trough levels.

Consider interaction with AED’s

• topiramate and carbemazapine good choices.

Question 2

Side effects of mycophenolate

Answer 2

Myelosupression

Malignancy (haematological)

Gut effects (diarrhoea)

Question 3

Side effects of tacrolimus

Answer 3

Tremor, tingling

Ailimentary, anaemia

Cancer risk increased

Renal toxicity

Ostoeporosis

Lymphoproliferative disease, low phosphate

Increased: blood pressure, K, Cr

Magnesium (low)

Urea (high)

Sugar diabetes