How is tacrolimus administered? Tacrolimus can be given by mouth (PO), intravenously (IV), or sublingual. Oral dosing, when initially given in combination with MMF or MPA, is 0.1 mg/kg per day. It is important to know if the tacrolimus is immediate release (twice daily dosing) or extended release (once daily dosing); the ratio is 1:1. …
Calcineurin Inhibitors nephrotoxicity Calcineurin Inhibitors nephrotoxicity can be divided into acute and chronic forms. • Acute nephrotoxicity usually involves afferent vascular constriction and lower kidney blood flow, leading to kidney ischemia and damage. This resolves with either removal of the drug or lower drug levels. TMA secondary to CNIs can present acutely as well. TMA can …
How are Calcineurin Inhibitors levels monitored? CNIs require trough monitoring to ensure an adequate degree of immunosuppression. The trough should be 12 hours after the last dose, so it is imperative the patient take the medication regularly at 12-hour intervals and plan for the lab about 30 minutes prior to the next dose. There is …
What are Calcineurin Inhibitors (CNIs)? Calcineurin Inhibitors remain a cornerstone of immunosuppressive regiments in kidney transplantation. This class of drugs works by blocking calcineurin, an intricate protein in the signal transduction pathway that activates signal 3. The two prototypes of the class are tacrolimus and cyclosporine, with tacrolimus being the primary drug of choice today. …
What are the main drugs used for maintenance therapy? 1. Calcineurin inhibitors (CNI): tacrolimus, cyclosporine 2. Anti-metabolites: azathioprine, mycophenolate mofetil (MMF), and mycophenolic acid (MPA) 3. mTOR (mammalian target of rapamycin) inhibitors: rapamycin and everolimus 4. Corticosteroids 5. Selective co-stimulation blockade: belatacept The most frequently used combination today is tacrolimus, anti-metabolite (MMF or MPA), and prednisone.
Immunosuppressive treatment in kidney transplantation What are the classes of immunosuppressive therapies used in kidney transplantation Common Drug Interactions INCREASE METABOLISM DECREASE CNI LEVELS DECREASE METABOLISM INCREASE CNI LEVELS Carbamazepine Ketoconazole Phenytoin Erythromycin Phenobarbital Clarithromycin INH Verapamil Rifampin DiltiazemNicardipine CNI , Calcineurin inhibitor.
Antihypertensive drugs to treat hypertension in pregnancy What antihypertensive drugs can be used to treat hypertension in pregnancy? Use of angiotensin converting enzyme inhibitor (ACEi) in the second and third trimester is associated with renal dysplasia, oligohydramnios, and neonatal death from hypoplastic lungs. Using ACEis in the first trimester may cause cardiac anomalies in the …
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