Post-Transplant Immunosuppressive Medications Flashcards

When should a transplant nurse administer the morning dose of tacrolimus relative to blood draws for trough levels?

Answer: After the blood draw is collected

Tacrolimus trough levels must be drawn before administering the morning dose to accurately reflect the lowest drug concentration during the dosing interval.

Which immunosuppressant is most associated with new-onset diabetes after transplantation (NODAT)?

Answer: Tacrolimus

Tacrolimus has the highest association with new-onset diabetes after transplantation (NODAT) due to its toxic effects on pancreatic beta cells and insulin secretion.

A heart transplant patient is prescribed azathioprine. What lab value requires close monitoring?

Answer: Complete blood count (CBC)

Azathioprine causes bone marrow suppression, so CBC monitoring is essential to detect leukopenia, thrombocytopenia, and anemia.

Which statement accurately describes maintenance immunosuppression in transplantation?

Answer: It consists of lifelong medications to prevent rejection

Maintenance immunosuppression consists of lifelong medications that continuously suppress the immune system to prevent rejection of the transplanted organ.

A patient taking tacrolimus is prescribed rifampin for tuberculosis. What effect should the transplant nurse anticipate?

Answer: Tacrolimus levels will decrease significantly due to CYP3A4 induction

Rifampin is a potent CYP3A4 inducer that markedly accelerates tacrolimus metabolism, requiring significant dose increases to maintain therapeutic levels.

What is the rationale for using triple immunosuppression therapy in most solid organ transplant protocols?

Answer: To block multiple pathways of immune activation while minimizing individual drug toxicity

Triple therapy targets different steps in the immune activation pathway, allowing lower doses of each agent and reducing toxicity while maintaining effective rejection prevention.