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Therapeutics Spring 2015 > Solid Organ Transplantation > Flashcards

Flashcards in Solid Organ Transplantation Deck (78)
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1

What is the average wait time for a kidney transplant?

4 years - long because we have dialysis

2

What is the average wait time for a liver transplant?

1 year

3

What is the average wait time for a heart transplant?

6 months- more critical

4

What are the 3 kinds of therapy associated with immunosuppression?

Induction therapy
Maintenance therapy
Rejection Therapy

5

What is induction therapy?

an intense level of immunosuppression at time of transplant
- Can allow delay of nephrotoxic calcineurin inhibitors

6

What is maintenance therapy?

Highly individualized therapy
Can be reduced as risk for rejection decreases

7

What is rejection therapy?

Used to decrease immune response and prevent allograft damage

8

What are 4 induction therapy agents?

Anti-thrombocyte globulin (thymogobulin)
Basiliximab
Alemtuzimab
methylprednisolone

9

What is the brand name of anti-thrombocyte globulin?

Thymoglobulin

10

What kind of antibody is thymoglobulin?

polyclonal rabbit
Depleting (depletes T cells)

11

What is the mechanism of thymoglobulin?

Binds to lymphocytes and causes lysis and depletion of lymphocytes

12

What kind of therapy is thymoglobulin used in?

induction and rejection treatment

13

What are some ADE of thymoglobulin?

myelosuppression
anaphylaxis
hypo/hpertension
tachycardia
dyspnea
urticaria
rash

14

What conditions require dose adjustment for thymoglobulin?

thrombocytopenia
leukopenia

15

How do you prevent infusion site reactions?

pretreat with acetaminophen, diphenhydramine and steroids
-central line administration/slow infusion rate

16

What are some dosing/administration characteristics of thymoglobulin?

IV through central line
Requires 0.22 micron filter
1st dose over 6 hrs, rest over 4hrs

17

What is the brand name of alemtuzumab?

Campath

18

What is the mechanism of action of alemtuzumb?

Depletes both T and B lymphocytes by binding to CD52 and causing cell lysis

19

What is alemtuzumab's place in therapy?

transplant induction therapy and acute rejection therapy

20

How is alemtuzumab dosed?

Single dose at time of transplant (IV)

21

What are some ADEs of alemtuzumb?

Infusion related rxns- pretreat
myeosuppression

22

What kind of antibody is alemtuzumab?

depleting antibody

23

what kind of antibody is basilixumab?

non depleting antibody

24

What is the brand name of basilixumab

simulect

25

What is the mechanism of action of basilixumab?

IL-2 receptor antagonist by binding to CD25 on T lymphocytes and prevents IL-2 activation and proliferation of t cells.

26

Where is basilixumab's place in therapy?

induction therapy

27

What are some ADEs of basilixumab?

not associated with infusion related reactions
hypersensitivity reactions

28

What are some dosing and administration characteristics of basilixumab?

2 doses IV, central or peripheral, over 30 min

29

What are 3 types of maintenance immunosuppressants?

Calcineurin inhibitors
antiproliferative agents
steroids

30

What kind of maintenance therapy is cyclosporine?

calcineurin inhibitor