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44 Cards in this Set
- Front
- Back
Transplant from different genotype?
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Allograft
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Transplant from genetically identical donor?
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Autograft
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Accelerated rejection occurs _____ after transplant
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24 hours- 4 days
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Acute rejection occurs ______ after transplant
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Days to months
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Chronic rejection occurs ______ after transplant
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Months to years
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Acute rejection is primarily due to activation of _____, mediated by?
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T-cells mediated by IL-2
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Induction agents are used to ______
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Induce immunity (prevent acute rejection)
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Name 2 types of induction agents
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Antibodies, IL-2 receptor antagonists
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How to antibody induction agents work?
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Reverse rejection by binding to angiotensin killer T-cells and interfering with their function
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How to IL-2 receptor antagonists work?
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Chimeric Monoclonal Antibodies that inhibit IL-2
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2 IL-2 receptor antagonists for induction?
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-Daclizumab (Zenapax)
-Basiliximab (Simulect) |
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All induction agents have what BBW?
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Use only by physicians experienced with immunosuppressive therapy
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Name 2 antibody induction agents
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-Antithymocyte globulin
-Muromonab-CD3 |
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Both antibody induction agents require premedication with?
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APAP + Benedryl + Steroid
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Name 4 classes of maintenance medications for organ transplant rejection
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-Corticosteroids
-Antiproliferative Agents -Calcineurin antagonists -MTOR kinase inhibitors |
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3 antiproliferative agents used for maintenance
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- Mycophenolate Mofetil
- Mycophenolic Acid - Azathioprine |
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Which antiproliferative agent is enteric coated and has decreased risk of diarrhea?
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Mycophenolic acid
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Cellcept
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Mycophenolate Mofetil
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Myfortic
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Mycophenolic Acid
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Imuran
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Azathioprine
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How to take Cellcept or Myfortic?
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On EMPTY stomach
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BBW of all antiproliferatives?
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Increased risk of infections, lymphomas, fetal damage
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Which antiproliferative agent needs monitoring for TMPT?
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Azathioprine
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Antiproliferative agents work by altering _______ synthesis
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Purine
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2 calcineurin antagonists
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-Tacrolimus (Prograf)
-Cyclosporine (Gengraf) |
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MOA of calcineurin antagonists?
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Suppress cellular immunity by inhibiting T-lymphocyte activation
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How to take calcineurin antagonists?
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On empty stomach
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BBW for cyclosporine (at high doses)
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Renal impairment
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5 major/important side effects of cyclosporine?
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-HTN
-Hirsutism -Gingival Hyperplasia -Hypertriglyceridemia -Neuropathy |
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3 brand names for cyclosporine
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Gengraf
Neoral Sandimmune |
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Are cyclosporine and cyclosporine (modified) interchangeable?
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No
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Which cyclosporine product is non-modified (less bioavailable)?
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Sandimmune
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Name 2 MTOR-kinase inhibitors
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-Sirolimus (Rapamune)
-Everolimus (Zortress) |
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Which MTOR-kinase inhibitor is NOT recommended in lung or liver transplant patients?
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Sirolimus
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Rapamune
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Sirolimus
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Zortress
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Everolimus
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Delayed wound healing and pneumonitis are 2 side effects of what class of anti-rejection medication?
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MTOR-kinase inhibitors
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Do not take any _______ pain relievers with immunosuppressants
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NSAIDs
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2 important side effects to counsel patients about while taking cyclosporine?
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-HTN
-Kidney problems |
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Which anti-rejection drug may CAUSE diabetes?
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Tacrolimus
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How to take mycofenolate?
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Q 12 Hours (VERY important to separate by as close to 12 hours are possible)
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Cyclosporine suspension?
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Neoral
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How to dilute Neoral?
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Room temperature orange or apple juice
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Cyclosporine effects on uric acid levels?
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Increases
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