transplant Flashcards
(32 cards)
Induction agents
rabbit
horse
alemtuzumab
basiliximab
major side effect of rabbit
leukopenia, thrombocytopenia
fever and chills (pre-medicate)
alemtuzumab AEs
T cell depletion
infusion related rxns
basiliximab pro
non-lymphodepleting
reserved for immunocompromised/cancer patients
calcineurin inhibitors
cyclosporine
tacrolimus
antimetabollites
azathioprine
mycophenolate mofetil
mycophenolate sodium
mTOR inhibitors
sirolimus
everolimus
t-cell co stimulation blocker
belatacept
what tacrolimus formulation is preferred and why
ER due to lower drug dose and less side effects
how are cyclosporines metabolized
cyp and PGP
cyclosporine half life
highly variable (10-40hr)
prolonged in hepatic disease or disorders of biliary excretion
cyclosporines AEs
hypertension
hypercholesterolemia
hypertriglyceridemia
gingival hyperplasia
hirsutism
tacrolimus AEs
neurotoxicity (headache)
insomnia
tremor
dizziness
hyperglycemia
alopecia
Azathioprine AEs
GI
bone marrow suppression
what is the most common antimetabolite used
mycopheenolic acid
mycophenolate pregnancy
teratogenic
mycophenolic DDIs
other suppressive drugs
what are the mTORs
sirolimus
everolimus
mTOR metabolism
cyp 3A4 and PGP
same DDIs as CNIs
what is sirolimus approved for
kidney rejection prophylaxis
what is everolimus approved for
kidney and liver transplant rejection prophylaxis
sirolimus and everolimus AEs
edema
hyperlipidemia
hypertriglyceridemia
impaired wound healing
mouth ulcers
proteinuria
belatacept contraindication
liver transplant
EBV negative patients
when to use belatacept
replacement or adjunct to CNI
