Transplant drugs

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Author:
Snooze
ID:
230424
Filename:
Transplant drugs
Updated:
2014-09-24 17:38:47
Tags:
transplant
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Description:
Transplant drugs
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  1. Which transplant medications are 3A4 substrates ? (3)
    • 1. Tacrolimus (Prograf)
    • 2. Cyclosporine (Sandimmune, Neoral, Gengraf)
    • 3. Rapamycin (Rapamune)
  2. What are the 3 dosage formulations of Tacrolimus?
    • IV (Prograf)
    • PO (0.5, 1, 5mg caps)
    • Topical (Protopic) - atopic dermatitis
  3. What should be monitored in usage of tacrolimus? (7)
    • CMP -->
    • 1. SCr (increase)
    • 2. BG (increase)
    • 3. K (increase)
    • 4. CBC (increase WBC's, risk of infx)
    • 5. BP (increase)
    • 6. Lipids (inc'd chol)
    • 7. TROUGH (5-20ng/ml)
  4. Counseling points with tacrolimus? (4)
    • -With or w/o food (empty stomach for decreased variability)
    • -May have stomachache and diarrhea
    • -Fine hand tremor (will go away over time)
    • -Hair loss, will resolve in ~6 months
  5. Conversion ratio of tacrolimus from IV to PO?
    IV/PO - 1:3
  6. Dosage formulations of Mycophenolate (CellCept)? (3)
    • IV
    • 250, 500mg caps
    • Oral susp (mixed, stable for 60d)
  7. Monitoring parameters for Mycophenolate? (7)
    • 1. CBC (inc WBC) - weekly x1month, 2x/month xmonth 2-3, then monthly for 1st year
    • 2. BP (inc)
    • 3. Electrolytes (HypoMg, K, Ca; HyperK)
    • 4. BG (inc)
    • 5. Lipids (inc chol)
    • 6. SCr and BUN (inc)
    • 7. Pregnancy test (BBW)
  8. What are the rules for usage of mycophenolate in women of childbearing age? (3)
    • -Must have negative pregnancy test
    • -2 forms of contraception starting 4 weeks prior to tx
    • -Contraceptives used during and for 6 weeks after d/cing med
  9. Counseling points for CellCept? (4)
    • -Separate Ca supplements by 2 hours
    • -Take on empty stomach
    • -May have stomach upset and diarrhea
    • -For women, must be on 2 contraceptives
  10. What are the dosage formulations of Cyclosporine (brand names)? (3)
    • 1. IV (SandImmune only)
    • 2. Caps (25, 50, 100mg) - all brands
    • 3. Oral soln (100mg/ml) 50ml- all brands
  11. Stability of cyclosporine formulations?
    • 1. IV - RT, ampules protected from light, stable for 6hr in PVC or 24hr in glass (POUR in glass)
    • 2. Caps - RT
    • 3. Soln - RT, use within 2 months and mixed in GLASS
  12. Monitoring parameters of cyclosporine? (4)
    • 1. BP
    • 2. SCr (inc)
    • 3. Lipids (inc TG's)
    • 4. Trough
  13. Counseling points of cyclosporine? (5)
    • -With or w/o fd
    • -May grow hair (hirsutism)
    • -Gum hyperplasia
    • -HA
    • -N/D
  14. Bioavailability of cyclosporine products?
    Neoral = Gengraf (MODIFIED = microemulsion) have increased bio availability

    Sandimmune is non-modified. Not interchangeable with above

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