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  1. Immunosuppressants increase the risk for
    • Infection
    • Neoplasms
  2. When to use immunosuppressants
    • Autoimmune diseases
    • Transplants
  3. Calcineurin Inhibitors
    most effective class of immunosupressants
  4. Cyclosporin (Sandimmune)
    Therapeutic uses
    Prevent transplant rejection

    to a lesser extent autoimmune diseases
  5. What class is Cyclosproin (Sandimmune)
    Calcineurin Inhibitor
  6. What is the action of Cyclosporin (Sandimmune)
    Calcineurin is needed for Interleukin 2 production (IL2)

    IL2 is needed for B and T cell proliferation

    Therefore, Cyclosporin suppresses B and T cell production, which are used in immunity
  7. What are the major side effects of Cyclosporin (Sandimmune)
    Nephrotoxicity and infection

    There is also a low risk for Lymphoma
  8. What does Cyclosporin not cause
    bone marrow suppression, so there is not a change in the number of RBCs
  9. When are levels for Cyclosporin (Sandimmune) drawn
    At the trough
  10. What is the route for Cyclosporin (Sandimmune)
    PO - can be as a pill or as a terrible tasting drink

    IV - there is a high risk for anaphylaxis
  11. What other considerations are there for Cyclosporin
    Sandimmune can not come in contact with plastic

    Keep it out of the light

    Grapefruit juice can increase levels
  12. What are the drug-drug interactions of Cyclosporin (Sandimmune)
    Anti-seizure medications can lower levels

    NSAIDs can increase a risk for kidney failure
  13. What class is Tacrolimus (Prograf)
    Calcineurin Inhibitor
  14. When is Tacrolimus (Prograf) used?
    ONLY for organ rejection
  15. Why is Tacrolimus (Prograf) used?
    It is a more effective medication for host rejection than Cyclosporin (Sandimmune), although it has a much higher incidence of side effects
  16. What are the major side effects of Tacrolimus (Prograf)
    • Nephrotoxicity
    • Infections
    • Malignancy
  17. If you have a patient who has recently been prescribed Cyclosporin (Sandimmune) while taking Dilantin. Why should you question this?
    Cyclosporin cannot be taken with anti-seizure medications. It will lower the therapeutic levels of Cyclosporin
  18. Cytotoxic Drugs
    Kill T and B cells undergoing proliferation to prevent immunity

    However, they are nonspecific and will kill ALL cells undergoing proliferation
  19. Cytotoxic Drugs side effects
    • Bone marrow depression
    • GI disturbances
    • hair loss
    • fertility problems

    • neutropenia
    • thrombocytopenia
  20. Who gets cytotoxic drugs
    People who have been unresponsive to safer immunosupressants
  21. Methotrexate (Rheumatrex) or Trexall is taken with what
    Combined with Cyclosporine (Sandimmune)
  22. Methotrexate (Rhematrex) is a class of what?
    Cytotoxic drug
  23. What is the action of Methotrexate (Rheumatrex)
    Suppresses T and B cell production by interfering with Folate metabolism
  24. What is the primary use for Methotrexate (Rheumatrex)

    Can also be used for arthritis and other autoimmune disorders, but in small doses
  25. How are all monoclonal antibodies given?
    IV, but can have a risk for anaphylax
  26. What class of Drug is Prednisone (Cortisone)
  27. What are the actions of Prednisone (Cortisone)
    1.) Suppresses lymphocyte proliferation

    2.) Sequesters extracellular lymphocytes

    3.) Reduces the responsiveness of T lmphocytes
  28. How is Cortisone given?
    In large doses, .5-2 mg/kg

    500-1500 mg for acute episodes
  29. What are the side effects of Glucocorticoids
    • Risk for infection
    • Endothelial loss
    • Fluid and electrolyte disturbances
    • Fat redistribution
  30. What are other side effects of Glucocorticoids
    • Osteoporosis
    • Muscle weakness/loss
    • Hyperglycemia
  31. What is endothelial loss?
    Thin skin and fragile veins

    Seen with glucocorticoid use
  32. When is RhoGAM given
    28 weeks gestation and 72 hours after delivery
  33. Who gets RhoGAM?
    An Rh- mother with an Rh+ fetus
Card Set:
2013-11-04 03:18:46

Pharmacology Exam 4
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