Transplant Flashcards
(20 cards)
CellCept indication / MOA
Transplant - renal, heart and liver transplant rejection prophylaxis
Antiproliferative agent - inhibits DNA replication and suppress B- and T-cell proliferation
CellCept generic
Mycophenolate Mofetil
CellCept dosing
Given PO usually twice daily
Max adult dosage: 3 grams per day
Max adolsecent and infant dosage: 2 grams per day
CellCept - pearls
Available as a 500 mg tablet and a 250 mg capsule - pay attention with additive dosing!
Powder for suspension - discard any unused portion 60 days after reconstitution, so do NOT dispense more than a 56 days supply (accredo reconstitutes)
Sandimmune indication / MOA
Transplant - renal, heart and liver transplant
Calcineurin Inhibitor - suppresses the activation of T lymphocytes by inhibiting the production of cytokines (first phase of T-cell activation)
Sandimmune generic
cyclosporine NON-modified
Cannot be used interchangeably with cyclosporine modified!
Sandimmune dosing
Dosed PO usually twice daily
dosing based on trough levels
Sandimmune pearls
always check DAW and history to confirm modified / non-modified
Solution expires 60 days after opened - enter this in the directions
All directions for solution should start with “Dilute and drink” - to make more palatable, should be diluted with orange or apple juice at room temperature in a glass container
North Carolina law - refilled using only the same product by the same manufacturer last dispensed unless the prescriber is notified prior to dispensing and the prescriber and the patient give consent to the dispensing of another mfr’s product
Neoral indication / MOA
Transplant - renal, heart and liver transplant
Calcineurin Inhibitor - suppresses the activation of T lymphocytes by inhibiting the production of cytokines (first phase of T-cell activation)
Neoral generic
Cylosporine modified
Cannot be used interchangeably with cyclosporine non-modified!
Neoral dosing
Dosed PO usually twice daily
dosing based on trough levels
Generic: 25 mg, 50 mg and 100 mg caps
Brand: 25 mg and 100 mg caps
Neoral pearls
always check DAW and history to confirm modified / non-modified
Solution expires 60 days after opened - enter this in the directions
All directions for solution should start with “Dilute and drink” - to make more palatable, should be diluted with orange or apple juice at room temperature in a glass container
North Carolina law - refilled using only the same product by the same manufacturer last dispensed unless the prescriber is notified prior to dispensing and the prescriber and the patient give consent to the dispensing of another mfr’s product
Imuran indication / MOA
transplant - renal
Antiproliferative agent - inhibits DNA replication and suppresses B- and T- cell proliferation
Imuran generic / alternate brands and available forms
azathioprine 50 mg tablets
Imuran 50 mg tablets
Azasan 75 mg and 100 mg tablets
Imuran dosing
1 mg to 30 mg/kg once daily
max adult dose in 3 mg to 5 mg/kg/day
adolescents and children - safety and efficacy not established. doses of 1-2 mg/kg/day PO for renal transplant have been used
Imuran pearls
Azasan (75 mg and 100 mg) is brand only
if patient is splitting tablets and it’s a ned med, need to set up a contact to make sure MDO wants patient to split tabs and set up ODT for consult to counsel patient on risk of splitting tablets
According to guidelines, an antiproliferative agent such as azatioprine is to be used for initial maintenance immunosuppression with a calcinurin inhibitor such as tacrolimus plus or minus corticosteroid - mycophenolate is suggested to the be first-line antiproliferative agent!
Myfortic indication / MOA
Renal, heart and liver transplant
antiproliferative agent - inhibits DNA replication and suppresses B- and T- cell proliferation
Myfortic generic
mycophenolic acid / mycophenolate sodium
NOT interchangable with CellCept
Myfortic dosing
Adults: 720 mg BID
max dose 1440 mg/day for anyone with BSA greater than 1.19
Myfortic pearls
transition from CellCept to Myfortic
cellcept 250 mg = myfortic 180 mg
