Transplant

Question 0

Prograf

Answer 0

Tacrolimus: calcineurin inhibitor-inhibit T cell activation
Take on empty stomach
ADR: increase BG (PTDM), K, cholesterol, BP, decrease WBC
Stomach upset/or diarrhea, hand tremor, hair loss
Monitors: renal, hepatic, glucose, electrolyte &BP
Blackbox warning: increases susceptibility to infection and possibly lymphoma
Major 3A4 substrate, avoid inhibitors & inducers

Question 1

Myfortic

Answer 1

Mycophenolic acid: inhibit T & B cell proliferation
Blackbox warning: increases of infections, lymphoma, skin malignancies, increase risk of malformations and abortions when used during pregnancy
ADR: diarrhea very common, GI upset, vomiting, increase BP
Take on empty stomach
Cellcept and Myfortic should not be used interchangeably
Myfortic is enteric-coated which helps to decrease diarrhea

Question 2

Neoral, Gengraf, Sandimmune

Answer 2

Cyclosporine: calcineurin antagonist
Gengraf and Neoral have higher bioavailability @ cannot use interchangeably with Sandimmune
Blackbox warning: renal impairment and other malignancies
Side effects: hypertension hirsutism, gingival hyperplasia, nephropathy

Question 3

Rapamune

Answer 3

Sirolimus: Mammalian target rapamycin (mTOR) kinase inhibitor
ADR: delayed wound healing, pneumotitis

Question 4

Zortress

Answer 4

Everolimus: mTOR kinase inhibitor inhibitor