Post-Transplant Immunosuppressive Medications Flashcards

A renal transplant patient on mycophenolate mofetil reports severe diarrhea and nausea. What is the most appropriate nursing intervention?

Answer: Document and notify the provider — dose reduction or switch to EC-MPS may be needed

GI toxicity is a common MMF side effect that may require dose reduction or conversion to enteric-coated mycophenolate sodium (EC-MPS) — the provider must be notified.

Cyclosporine A is associated with which distinctive cosmetic side effect not seen with tacrolimus?

Answer: Gingival hyperplasia

Gingival hyperplasia is a distinctive side effect of cyclosporine that is not typically seen with tacrolimus, making dental hygiene especially important.

Which drug interaction is most clinically significant for transplant patients taking tacrolimus?

Answer: CYP3A4 inhibitors such as fluconazole significantly increase tacrolimus levels

Tacrolimus is metabolized by CYP3A4, so inhibitors like azole antifungals can dramatically increase tacrolimus blood levels, risking toxicity.

Prednisone is used in transplant regimens primarily for which mechanism?

Answer: Broad anti-inflammatory and immunosuppressive effects via glucocorticoid receptor activation

Prednisone acts through glucocorticoid receptors to broadly suppress inflammation and immune activation, making it useful as maintenance and anti-rejection therapy.

A liver transplant patient is started on sirolimus. Which side effect should the nurse educate the patient about?

Answer: Impaired wound healing and hyperlipidemia

Sirolimus commonly causes impaired wound healing and hyperlipidemia, and is often avoided in the early post-transplant period for these reasons.

Basiliximab is an induction agent that acts by blocking which interleukin receptor?

Answer: IL-2 receptor (CD25)

Basiliximab is a monoclonal antibody that blocks the IL-2 receptor (CD25) on activated T cells, preventing IL-2-driven proliferation.