Transplant Flashcards
(30 cards)
What is the difference between allograft and autograft?
- Allograft: from one individual to another
- Autograft: from same patient
What does rejection mean?
- Immune response to allograft (transplant failure - may need immunosuppressant drugs)
Out of the ABO blood groups, which of them are the universal donors and which are the universal receivers?
- Receiver: AB (get blood from anyone)
- Donor: O (can give blood to anyone)
What is induction immunosuppression?
- immunosuppression given right before or at the time of transplant to prevent rejection
Which drugs are most commonly used for causing induction immunosuppression?
- Basiliximab (ONLY for prevention)
- Antithymocyte Globulin (for prevention and treatment)
What drug is the Interleukin-2 Receptor Antagonist and what is it MOA?
- Basiliximab (Simulect)
- Monoclonal antibody that inhibits IL-2 receptor on the surface of T-lymphocytes
What are the different types of antithymocyte globulins and what is their MOA?
- Atgam (Horse) & Thymoglobulin (Rabbit)
- Binding to T-Lymphoytes and interferes with their function
What are the Boxed warnings for the Antithymocyte Globulins?
- Anaphylaxis
What are the side effects for the Antithymocyte Globulins?
- Infusion Related Reactions (decrease BP, Fever, Chill, Rash, Icthy)
What are some additional notes for the antithymocyte globulins?
- Premedicate (with Benadryl, Tylenol, Steroid) to less those infusion reactions
What is the typical maintenance immunosuppression regimen that is used for Transplant?
- Calcineurin Inhibitors (i.e.; Tacrolimus)
- Antiproliferative Agent (i.e.;Mycophenolate)
- +/- Steroids (i.e; Prednisone)
What is the MOA of the Calcineurin Inhibitors?
- Inhibits T-Lymphocyte activation
What are the Calineurin Inhibitors that are used?
- Cyclosporine
- Restasis (eye drops)
- Tacrolimus (Prograf)
What are the Boxed warnings for cyclosporine used for transplant?
- Increased risk of malignancy
- Increased risk of infections
- Nephrotoxicity
- Increased BP
What are some of the Side effects of Cyclosporine used for transplant?
- Increased Glucose
- Hyperkalemia
- Hypomagesemia
- Hair growth
- Neurotoxicity
- Hyperuricemia
What are some things to monitor with Cyclosporine used for transplant?
- Cyclo Levels
- Electrolytes (K, Mg)
- Renal Function
- LFTs
- Glucose
- Blood Pressure
What are some boxed warnings for Tacrolimus used for transplant?
- Increased risk of malignancy
- Increased risk of infection
What are some side effects for tacrolimus used for transplant?
- Increase Blood Pressure
- Increased Glucose
- Hyperlipidemia
- Nephrotoxicity
- Hypomagnesemia
- Neurotoxicity
What are some things to monitor with tacrolimus?
- Tacro Levels
- Electrolytes (K, Phos, Mg)
- Renal Function
- LFTs
- BP
- Glucose
What is the MOA of the antiproliferative agents?
- Inhibits T- and B-Lymphocytes by altering purine nucleotide synthesis
What are the antiproliferative agents that are used for Transplant?
- Azathioprine
- Mycohenolate Mofetil (CellCept)
- Mycophenolic Acid (Myfortic)
What are some of the boxed warnings for Antiproliferative agents?
- Increased risk of Malingnacy
- Increased risk of infections
- Increased risk of congential malformationa dn spontaneous abortions
What are some side effects of the antiproliferative agents?
- Diarrhea
- Abdominal Pain
- Nausea
- Vomiting
What are some additional notes about the antiproliferative agents used for transplant?
- REMS
- CellCept and Myfortic are NOT interchangeable (CellCept 500 mg = Myfortic 360 mg)
- Myfortic is EC to decrease diarrhea
- Decreases effectiveness of Contraceptives
