Transplantation And Immunosuppression

Front 1

Transplant from different genotype?

Back 1

Allograft

Front 2

Transplant from genetically identical donor?

Back 2

Autograft

Front 3

Accelerated rejection occurs _____ after transplant

Back 3

24 hours- 4 days

Front 4

Acute rejection occurs ______ after transplant

Back 4

Days to months

Front 5

Chronic rejection occurs ______ after transplant

Back 5

Months to years

Front 6

Acute rejection is primarily due to activation of _____, mediated by?

Back 6

T-cells mediated by IL-2

Front 7

Induction agents are used to ______

Back 7

Induce immunity (prevent acute rejection)

Front 8

Name 2 types of induction agents

Back 8

Antibodies, IL-2 receptor antagonists

Front 9

How to antibody induction agents work?

Back 9

Reverse rejection by binding to angiotensin killer T-cells and interfering with their function

Front 10

How to IL-2 receptor antagonists work?

Back 10

Chimeric Monoclonal Antibodies that inhibit IL-2

Front 11

2 IL-2 receptor antagonists for induction?

Back 11

-Daclizumab (Zenapax)
-Basiliximab (Simulect)

Front 12

All induction agents have what BBW?

Back 12

Use only by physicians experienced with immunosuppressive therapy

Front 13

Name 2 antibody induction agents

Back 13

-Antithymocyte globulin
-Muromonab-CD3

Front 14

Both antibody induction agents require premedication with?

Back 14

APAP + Benedryl + Steroid

Front 15

Name 4 classes of maintenance medications for organ transplant rejection

Back 15

-Corticosteroids
-Antiproliferative Agents
-Calcineurin antagonists
-MTOR kinase inhibitors

Front 16

3 antiproliferative agents used for maintenance

Back 16

- Mycophenolate Mofetil
- Mycophenolic Acid
- Azathioprine

Front 17

Which antiproliferative agent is enteric coated and has decreased risk of diarrhea?

Back 17

Mycophenolic acid

Front 18

How to take Cellcept or Myfortic?

Back 18

On EMPTY stomach

Front 19

BBW of all antiproliferatives?

Back 19

Increased risk of infections, lymphomas, fetal damage

Front 20

Which antiproliferative agent needs monitoring for TMPT?

Back 20

Azathioprine

Front 21

Antiproliferative agents work by altering _______ synthesis

Back 21

Purine

Front 22

2 calcineurin antagonists

Back 22

-Tacrolimus (Prograf)
-Cyclosporine (Gengraf)

Front 23

MOA of calcineurin antagonists?

Back 23

Suppress cellular immunity by inhibiting T-lymphocyte activation

Front 24

How to take calcineurin antagonists?

Back 24

On empty stomach

Front 25

BBW for cyclosporine (at high doses)

Back 25

Renal impairment

Front 26

5 major/important side effects of cyclosporine?

Back 26

-HTN
-Hirsutism
-Gingival Hyperplasia
-Hypertriglyceridemia
-Neuropathy

Front 27

3 brand names for cyclosporine

Back 27

Gengraf
Neoral
Sandimmune

Front 28

Are cyclosporine and cyclosporine (modified) interchangeable?

Back 28

No

Front 29

Which cyclosporine product is non-modified (less bioavailable)?

Back 29

Sandimmune

Front 30

Name 2 MTOR-kinase inhibitors

Back 30

-Sirolimus (Rapamune)
-Everolimus (Zortress)

Front 31

Which MTOR-kinase inhibitor is NOT recommended in lung or liver transplant patients?

Back 31

Sirolimus

Front 32

Delayed wound healing and pneumonitis are 2 side effects of what class of anti-rejection medication?

Back 32

MTOR-kinase inhibitors

Front 33

Do not take any _______ pain relievers with immunosuppressants

Back 33

NSAIDs

Front 34

2 important side effects to counsel patients about while taking cyclosporine?

Back 34

-HTN
-Kidney problems

Front 35

Which anti-rejection drug may CAUSE diabetes?

Back 35

Tacrolimus

Front 36

How to take mycofenolate?

Back 36

Q 12 Hours (VERY important to separate by as close to 12 hours are possible)

Front 37

How to dilute Neoral?

Back 37

Room temperature orange or apple juice

Front 38

Cyclosporine effects on uric acid levels?

Back 38

Increases