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Organ Transplant Dru
Brand and Generic for organ transplant drugs
| Question | Answer | ||
|---|---|---|---|
| brand: Prograf | tacrolimnus | Calcineurin inhibitor IV mg/kg; PO BID adjust to Ctrough ( 5-20ng.ml) halfe life =8hrs | ADRs: alopecia, hepatotoxicity, n and anemia, plus DM (big TIME) plus electrolytes imbalance |
| Brand: Rapamune | sirolimus PO only -no IV | MTOR monitor to trough 5-20 similar to prograf | with cyclosporin big interaction (level changed) also, hyperkalemia and esophagitis, gastritis, and gastroenteritis - hepatotoxcitiy, HYPERkalemia, just like C2inhibitors (prograf and saniume/neoral)\lots of heme effects (so is azathioprine) |
| Brand: Imuran | azathioprine PO/IV daily | Antiproliferative agents NO NEED to monitor for trough | Bioavailabity changed in uremic patients b/c of the xanthine oxidase rspb for elimination , also allopurinol (reduce dose byy 65-75% if concurrent use); lots of heme effects and liver, eye effects also |
| Brand: Cellcept | mycophenolate mofetil | antiproliferative agents; works on inosine monophosphate dehydrogenaase from forming purine synthesis PO BID IV BID; slow infusion | doesnt matter if take with or w/out food. no need to monitor trough either heme: preetty bad HEME effects, that's about it mycophen. acid seems to be a big deal - in reduction of exposure Drug I: can reduce efficacy of oral contraceptive |
| Brand: MYfortic | mycophenolate sodium | PO :BID WITHOUT FOOD | take WITHOUT food (30min b4 or 2 hrs after) no need to monitor levels |
| Orthoclone OKT3 | Muromonam CD3 - induion IV qday x 10-14d IV only | Monoclonal antibodies -against all CD3 delineated cell line Monitor CD3 cells < 25cells /mm3; given as: 1 dose daily for 7-110 days; for acute rejection daily dose for 10-14 days | require premedication due to the high infusion related reactions; also assess volume status carefully due to risk of pulmonary edema; IV bolus over less than 1 minte infusion; cool ADRS: photophobia, transiet lymphopenia, pumonary edema Monitor CD3 ce |
| brand: Simulect | basiliximab: chimeric murine human; | monoclonal antibodies CD25 hit -- of Il2 recpetors; given as induction day 0 and day 4 | anaphylaxis occur w.in 24 hrs - CD24 sat above concernttion of 0.2mcg/ml; |
| brand: zenapax | daclizumab | monoclonal induction: 1mg.kg iv q2week for 5 doses total | humanized monoclonal; hypersensitivituy cd25 sat at 5-10mg/ml =- last 120dayts ; no monitoring ; |
| brand: atgam | ATG equine | polyclonal ab induction daily 7-14 d; acute rjection daily 14d | required premedication, adminster 4-6hrs centrally!!! infusion related rxn , leipkepenia, thrombocytpone, or rash goal: cd lineage cells <50cells/mm3 |
| brand: thymoglobulin | ATG rabibit | polyclonal ab induction: daily 3-7 d acute rejection: daily x 7-14d | 2 compartment model: terminal elimintaiot half life = 2-3 days fris dose range 14-45 days with multiple doses; cd3 lineage < 50cells/mm3 |
| Brand: Sandimmune | Generic: cyclosporin usp Drug class? Dosing? Monitoring? | Calcineurin inhibitor IV/PO q12h C through/C2 Others? | WITH FOOD highly lipophilic; bile for emulsion; lots of ADRS, increase K and uric acid, lower Mg; hirsutism hepertrichosis |
| brand: Neoral | cyclosporin uSP modifed differences | shorter half life ( 8hrs vs 19 hrs) - improved bioavailability and more consistent absorption | similar to Sandiumune |
Created by:
nhocloncon
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