Tacrolimus Flashcards
(23 cards)
What is required for tacrolimus dosing?
Loading doses may be required
Consult local guidelines for therapeutic dosing and monitoring.
What should be monitored in whole blood-tacrolimus?
Trough concentration
Particularly during episodes of diarrhoea.
What are some warning signs to monitor while on tacrolimus?
Blood pressure, ECG, fasting blood glucose, renal function, liver function, serum electrolytes, haematological, neurological, coagulation parameters
Special attention to K’ levels.
What neurotoxic effects may occur with tacrolimus?
Tremor, headache
What nephrotoxic effect is associated with tacrolimus?
Elevated serum creatinine concentrations
What visual symptoms may indicate eye disorders with tacrolimus?
Blurred vision, photophobia
What skin disorders can arise from tacrolimus use?
Rash, toxic epidermal necrolysis
What blood disorders should be monitored in patients taking tacrolimus?
Leucopenia, thrombocytopenia
Signs of infection include fever, sore throat, mouth ulcers, unexplained bruising or bleeding.
What symptoms indicate hyperglycaemia in tacrolimus patients?
Increased thirst, excessive urination
What cardiovascular disorders should be monitored with tacrolimus?
Cardiomyopathy, arrhythmias, hypertension
Symptoms include irregular heartbeat and heaviness in the chest.
What liver toxicity symptoms should be reported?
Jaundice, nausea, vomiting, abdominal discomfort, dark urine
What actions should patients take if warning signs occur?
Report immediately to a doctor
What UV exposure precautions should tacrolimus patients take?
Avoid excessive exposure and use a wide-spectrum sunscreen
Why should oral tacrolimus be prescribed by brand name only?
To minimize switching between products and reduce risk of toxicity and graft rejection
What should patients understand about taking immunosuppressants?
The importance of taking them regularly
What activities should be avoided while on tacrolimus?
Skilled tasks (e.g. driving) if feeling unfit
What type of vaccines should patients on tacrolimus avoid?
Live vaccines
What dietary restrictions should tacrolimus patients follow?
Avoid a high potassium diet and grapefruit juice
What effect does tacrolimus have on ciclosporin plasma concentration?
Increases plasma concentration
Which medications may increase plasma concentrations when taken with tacrolimus?
Clarithromycin, diltiazem, erythromycin, fluconazole, grapefruit juice, itraconazole, nifedipine, omeprazole, ranolazine
Which medications may reduce plasma concentration of tacrolimus?
Phenobarbital, St. John’s Wort, rifampicin, phenytoin
What is the risk when tacrolimus is given with certain antibiotics?
Increased risk of nephrotoxicity with aminoglycosides, amphotericin, NSAIDs
What is the risk of hyperkalaemia when tacrolimus is taken with potassium-sparing diuretics?
Increased risk
Examples include amiloride and spironolactone.
