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DRUGS > Solid Organ Transplant > Flashcards

Solid Organ Transplant Flashcards

(18 cards)

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1
Q

Rabbit Antithymocyte Globulin and Horse Antithymocyte Globulin

A
  • Polyclonal Antibodies
  • Induction Immunosuppression
  • Lymphocyte Depletion x3months
  • AE: Leukopenia, thrombocytopenia
  • pre-med w/ Beny + APAP
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2
Q

Alemtuzumab

A
  • Monoclonal Antibodies
  • Induction Immunosuppression
  • profound depletion of T cells (antibody-dependent cellular toxicity)
  • AE: infusion related chills, rigors, fevers
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3
Q

Basiliximab

A
  • IL-2a receptor antagonist
  • Induction Immunosuppression
  • Non-lymphodepleting
  • Use if pt has: Hx of malignancy, high infxn risk, immunocomped, HIV, age >65
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4
Q

Cyclosporine

A
  • Calcineurin-i (CNI)
  • Maintenance Immunosuppression
  • metabolized by PGP
  • Non-modified and Modified forms are NOT interchangeable
  • Variable half life
  • AE: HTN, Hypercholesterolemia, Hypertriglyceridemia
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5
Q

Tacrolimus

A
  • Calcineurin-i (CNI)
  • Maintenance Immunosuppression
  • Immediate release and extended release
  • Neurotoxicity, hyperglycemia, Alopecia
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6
Q

CYP450 Inducers

A
  • Dec [CNI] and [mTOR-i]
  • Phenytoin
  • Carbamazepine
  • Phenobarbital
  • Rifampin
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7
Q

CYP450 Inhibitors

A
  • Inc [CNI] and [mTOR-i]
  • Erythro/Clarithromycin
  • Azoles
  • Diltiazem, Verapamil
  • Ritonavir
  • Grapefruit juice
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8
Q

Azathioprine

A
  • Antimetabolite
  • Maintenance Immunosuppression
  • AE: Bone marrow suppression, anemia, leukopenia, neutropenia, thrombocytopenia
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9
Q

Mycophenolic Acid (MPA)

A
  • Antimetabolite
  • Maintenance Immunosuppression
  • MMF and MPS are equivalent/interchangeable
  • AE: Teratogenic (REMS, need 2 forms of BC)
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10
Q

Sirolimus

A
  • mTOR-i
  • Maintenance immunosuppression
  • for KIDNEY transplant rejection PTx
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11
Q

Everolimus

A
  • mTOR-i
  • Maintenance Immunosuppression
  • for KIDNEY AND LIVER transplant rejection PTx
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12
Q

mTOR-i AE’s

A
  • Edema
  • Inc TG
  • Inc Lipids
  • impaired wound healing (don’t use immediately post-up)
  • mouth ulcers
  • proteinuria
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13
Q

Belatacept

A
  • T-cell Co-Stimulation Blocker
  • Maintenance Immunosuppression
  • CI: liver transplant, EBV seronegative pts
  • q4w at an infusion center
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14
Q

Most common Triple Drug Regimen

A

Tacrolimus (CNI) + Mycophenolate (antimetabolite) +/- Prednisone

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15
Q

Pros/Cons of avoiding/minimizing CNI

A
  • PRO: inc renal function
  • CON: Inc risk of acute rejection
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16
Q

Rejection Immunosuppressive Regimens - Acute Cellular Rejection (ACR)

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A
  • Mild-Mod: Methylprednisolone 250-1000mg IV x3-5d
  • Mod-Severe: Rabbit Antithymocyte Globulin IV x 6-7d
  • Refractory: Alemtuzumab
17
Q

Rejection Immunosuppressive Regimens - Antibody Mediated Rejection (AMR)

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A

Steroids +/- Rituximab +/- IVIG

18
Q

When to dose adjust CNIs

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A

LIVER Dysfunction

DRUGS (37 decks)

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