Transplantation

Card Set Information

Author:
alvo2234
ID:
252084
Filename:
Transplantation
Updated:
2013-12-09 22:35:54
Tags:
Dr Ramirez
Folders:
PT,III,final
Description:
final
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  1. MOA of alemtuzamab
    CD-52 inhibitor
  2. agents utilized in induction
    • basiliximab
    • corticosteroids
    • alemtuxumab
  3. MOA of simulect
    basiliximab is a monoclonal antibody which inhibits IL-2
  4. indication of basiliximab
    simultect is indicated for induction
  5. what is the MOA of alemtuzumab
    campath is a monoclonal antibody that inhibits CD-52 surface antigen found on T and B lymphocytes
  6. indication for Methylprednisolone/prednisone
    • induction
    • maintenance
    • rejection
  7. agents utilized in maintenance phase
    • cyclosporine
    • tacrolimus
    • mycophenolate salts
    • azathioprine
    • sirolimus
  8. MOA of cyclosporine
    calcineurin inhibitor. Inhibits T-cell proliferation by inhibiting IL-2 and other cytokine production

    calcineurin activates the nuclear factor of activated T-cells which is responsible for transcription of several key cytokines.
  9. MOA of tacrolimus
    prograf is a calcineurin inhibitor. inhibits IL-2 and other cytokine production.
  10. MOA of mycophenolate mofetil
    CellCept is a inosine monophosphate dehydrogenase which inhibits de novo guanosine nucleotide synthesis. 

    T and B lymphocytes are dependent on this pathway
  11. MOA of mycophenolate sodium
    • myfortic inhibits IMPDH 
    • enteric coated sodium salt of MPA
  12. azathioprine MOA
    antimetabolite that inhibits the purine metabolism
  13. MOA of sirolimus
    • rapamune is a mTOR inhibitor
    • binds to FKBP12---binds to mTOR---cell cycel arrest at Gi-S---inhibits cell proliferation
  14. agents utilized in rejection
    • rabbit and equine globukin
    • immune globuline (IVIG)
    • CMV immune globulin
    • rituximab
    • bortezomib
  15. MOA of equine abd rabbit/RATG
    thymoglobulin is a polyclonal ant-lymphocyte antibody that binds to various CD receptors and MHC I and II antigens
  16. uses of Atgam
    • induction
    • steroid resistant rejection
  17. uses of thymoglubulin
    steroid resistant rejection
  18. MOA of privigen
    provides passive immunity by increasing the antibody titerand antigen antibody reaction potential
  19. CMV MOA
    cytogam is a immunoglobulin  (IgA and IgM) and contains high titer of CMV antibodies
  20. MOA of bortezomib
    Velcade is a proteosome inhibitor. proteosomes regulate protein homeostasis and lead to the activation of signaling cascades
  21. complications associated with transplantation
    • delayed-graft function
    • opportunistic infections
    • excessive immunosuppression
  22. what is the definition of delayed-graft function
    • rise in creatinine by >1mg/dL/day
    • persistent oliguria (< 0.5)
    • need for post operative hemodialysis
    • usually occurs between POD 3-7
  23. tx for delayed-graft function
    • rabbit serum RATG
    • pulse steroid + taper
  24. opportunist infections associated with transplants
    • CMV
    • pneumocystis pneumonia
    • fungal infections
  25. agents used to treat CMV
    • ganciclovir
    • valganciclovir
    • valacycolvir
  26. agents used to treat pneumocystis pneumonia
    • bactrim 
    • dapsone
  27. agents used to treat fungal infections
    • nystatin
    • fluconazole
  28. agents used to treat BK virus
    leflunomide

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