Transplant/intro/induction/depleting Ab

Terms	Definitions
After the introduction of these drugs, rejection rate decrease and survival rate increased	Cyclosporine Tacrolimus MMF Thymoglobulins Sirolimus
In what time frame do we use LARGE doses of immunosuppressant drugs in early transplant period	From day they get new organ to 6 months
Immunosuppressive therapy is required for how long after transplant	indefinitely
Do we use a multi drug regimen after transplant?	yes, usually 2-3 drugs used
When does patient receive the first dose of immunosuppressant?	Before the surgery
What is the Induction IST: goals and target?
What are the guidelines for choosing IST	There are none. Based on local research results
How many classes of drugs are available for tx?	5 classes
What are the drug classes for tx?
What is the purpose of induction therapy?
What type of cells re depleted in the induction therapy	T cells
What are the significant SE from induction therapy
What two types of drugs do we use in Induction Therapy	Polyclonal and Monoclonal Abs
Which of the two classes of drugs used in induction tx are non specific and deplete all T-cells	Polyclonal Antibodies
what are the two sources of ATG?
What is ATG used for?	Induction Rejection
What is the MOA of ATG?
What are some early stage adverse effects for ATG?
What are some delayed AE for ATG?
What meds to give for the hypersensitivity of ATG early phase AE?	Acetaminophen benadryl:20-50mg solu-medrol
What was the first Monoclonal Ab Used?	Muromonab CD3 (OKT3)
Which Ab binds to the CD3 antigen and forms complex with the T-call receptor (TCR)?	OKT3-Muromonab CD3
What can OKT3 be used for?
Which Ab is completely from a mouse source?	OKT3-Muromonab CD3
What is the big problem that we have with OKT3 and reason why we don't use as often?	Cytokine Release Syndrome
Which monoclonal Ab is no longer in the market?	Daclizumab (Zenapax)
What is the source of Basiliximab?	Chimeric
Which monoclonal Ab is an Interleukin 2 receptor antagonist and acts as a competitive inhibitor to the receptor?	Basiliximab
Which Mon. Ab don't affect quiescent T cells	Basiliximab
Which Mon. Ab is used only for induction in low risk patients?	Basiliximab
What is the dose of Basiliximab?
Does Basiliximab need dose adjustment for gender or renal impairment?
What are some AE of Basiliximab?	Less AE than OKT3
What are the Induction doses and duration for ATG?	10-20 mg/kg for 7-14 days
WHat is the induction dose and duration for Thymoglobulin?	1.5 mg/kg for 7-14 days
What is the induction dose and duration for OKT3?	5 mg for 7-14 days
What is the induction dose for Basiliximab and the duration?	20 mg on Day1 and Day4
When do we use IL2 receptor antagonists?	In INDUCTION tx
Is IL2 receptor antagonists better tolerated than ATGs?	Yes
Which drug class can be safely used with a low initial doses of cyclosporine?	IL2 receptor antagonists