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KIDNEY TRANSPLANT

Q.707.What are the adverse effects of this group of drugs?

 KIDNEY TRANSPLANT

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Q.707.What are the adverse effects of this group of drugs?  👎

A.Sirolimus (Siros) is ass. é 🠞[leukopenia, thrombocytopenia, anemia, hyperchlst., hyperTrG, Drr., etc.]. Hematologic effects: [Anemia, thrombocytopenia & leukopenia.]. Anemia rep. in 27-57% of ptns. Combination of [MMF+ Siros]🠞🠝incidence of anemia. Thrombocytopenia obs. in 13-30 % of ptn... Reductions in platelet count are dose-related & us. occur 9-10 d. after initiation of ttt . Normalization of platelet counts is seen é 2 w. of discontinuation . Leukopenia, wch’s not dose-related, is evident é 2 w. of start of therapy & reversed upon discontinuation.

HUS/TMA: Rep. é Csp/Siros combin.: HUS was rep. in 10 ptns. on Csp/Siros. Higher Csp & Siros levels thn those ptns without HUS & discontinuation of these ag.s🠞reversal of HUS in most cases. Incid.of HUS ws lower on a reg. of Csp/Siros comp. to controls on a Tcrol or Csp. based reg. without Siros Single cohort study: 13 of 368 ptns dev. biopsy proven TMA. Incidence was highest é Csp/Sirs (20%) comp. é other reg., include Csp+MMF, tcrol+MMF & tcrol+ Siros. An incr. rate of hepatic a. thrombosis, graft loss & death ws rep. in liver Tx. recip.. In two multicenter, trials in de novo liver Tx. recip., use of Sirosin combin. é either Csp or Tcrol ws ass. é 🠝 rate of hepatic a. thrombosis . Furthermore, in one phase II study, use of Siros+tcrol was associated é 🠝rate of death & graft loss.

Hyperlipidemia & hyperchlst.: dose-related effects of Siros due to 🠟lipoprotein lipase. Long-term Rapa 🠞🠟gluc. metabism & new onset D.M..                  G.I.: S.E.: [constipation, Drr.,dyspepsia, n. & v.]. Mouth sores, not rel. to herpes simplex, have been rep. é Siros oral solution & usually dose-related. Oral ulcers may occur é combin. of [Siros+MMF] & sn more frequently in steroid-avoidance protocols .                                                                                              Respiratory system:  Progressive interstitial pneumonitis has been observed. Increased risk for pneumonitis é late switch to Siros &🠟R. function. Sms incl.:[SOB, dry cough, fever & fatigue]. In one rep.: radiographic & BAL🠞bronchiolitis olibertans-organizing pn. & lymphocytic alveolitis. Complete recovery occ. é 6 m. of Siros withdrawal.

Kidney func.: Siros is minimally nephrotoxic if used alone. However, combin. of Siros/Csp 🠞 synergistic nephrotoxicity in animals & humans, wch may be due to 🠝 R. & whole bld Csp levels and/or resultant incr. in fibrogenic cytokine TGF-B . Phase III clinical trials using Siros+Csp 🠞🠝 s. cr. &🠟GFR. These effects were not obs. é Csp & placebo or Aza controls. In addition, combin. of Siros/Tcrol, compared é Tcrol/MMF, is consistently ass. é dcrease R. func.in several studies. R. func. should therefore be carefully monitored in combin. thpy of [Siros & CNI].There’s some evidence that Siros 🠞DGF. Study: of deceased or living donor kid. allog. recip., DGF ws signif. more common é Rapa thn without this ag..

Proteinuria: Siros🠞proteinuria & G.N. (esp. FSGS): “Study”: Siros ws substitu-ted for a CNI, Prot ws assessed prior to & after substitution. Comp. é baseline, Prot markedly incr. & reversed é Siros withdrawal. Ptns. converted to Siros, dev. Prot, é 30 % develop FSGS. “Collapsing FSGS” rep. é Siros, used é Kaposi's sarco-ma. Mech. of Prot.: Siros🠞🠟tubuler protein reabsorption, podocyte dysregulation & over expression of vsc. endoth. growth f, 🠞🠝cell wall permeability 🠞collapsing FSGS.

Others: A unique form of cast nephropathy has been described é DGF & exten-sive tub. dge é use of [Tcrol + Siros]. Casts were histologically indistinguishable fr. those of myeloma Np. ARF occur in ass. é myoglobinuria & myoglobulin-appearing casts hs also bn rep. é Siros. Other rep. have noted 🠝 risk of DGF. Malignancy: PTLD is uncommon among those given Siros & Csp. There’s also some evidence that Siros may actually have anti-malignancy effects.

Teratogenicity/effects in pregnancy & fertility: Siros is C.I. in pregnancy & its use shd be discontinued at least 12 w. prior to attempted conception. Women post-Tx. who wish to conceive shd be switched prior to conception fr. Siros to Csp or Tcrol. Upon delivery, mother shd switch back👉to her basal im/m. in view of potential benefits of the newer ag.s to prevent late Ac. Rj. & CAN.

Siros🠞🠟spermatogenesis. Study: of 95 recep., total sperm count was signif. lower é Siros. Ptn receiving Siros-based reg. hd signif. decrease fathered pregnancy rate comp. é Siros-free regimen. So, men shd be informed of risks/benefits of Siros.

Others: Siros has been associated é leukocytoclastic vasculitis & postoperative wound complications. There’s 🠝incidence of angioedema é ACEI+ either Siros or evrol.

Cutaneous: the most frequent é Siros:🠞[acne-like eruptions , scalp folliculitis , hidradenitis suppurativa , edema , angioedema , aphthous ulceration & epistaxis]. Pericardial effusion have been rep. é Siros therapy, in cardiac & R. Tx. recip..

Evrol has not bn comp. to Siros in direct trial, but in non-comp. trials, S.E. are similar. Comp. MMF to evrol in conjunction é Csp, most common S.E. é evrol:[peripheral edema, constipation, H.T., nausea, anemia, UTI & hyperlipidemia].

Q.708. What drug interactions are known for these medications?    

A. As {Siros & evrol} are substrates for cytochrome P450 3A, coadministration of [Siros + cytochrome P450 3A inducers] (anticonvulsants, rifampin, INH, St. John's wort) & é cytochrome P450 3A inhibitors (e.g. azole antifungals, non-DHP CCB, macrolide A.B., grapefruit)  🠞Significant interactions.  òñ

Cyclosporin: Concurrent use of [Siros +Csp]🠞significantly higher peak/ trough levels & area under conc.-time curve (AUC) if comp. to giving 4 h. apart. This ws shown in a single dose drug interaction study in wch Siros 10 mg & Csp 300 mg (Neoral) oral soft gelatin cp. given either simultaneously or 4 h. apart . When given together, Siros Cmax & AUC were incr. by 116 % & 230 %, resp., relative to Siros alone. Whole-blood trough levels increased by 30 % é concomitant dosing, and time to peak levels ws also shorter (1.8 vs 2.5 h.). By comp., when Siros given 4 h. after Csp, Cmax & AUC were incr. by 37 % & 80 %, resp., comp.  to Siros alone. The mean Csp Cmax & AUC were not significant affected by Siros if given concomitantly or 4 h. after Csp. Because of these interactions & additive S.E. (hyperTrG, possibly HUS/TTP) é Csp, we prefer not to use Csp + Siros. Nevertheless, when we do use combin. of [Csp+ Siros], it’s us. é setting of using Siros as either rescue thpy or to help reduce Csp toxicity. So, it’s recomm. : time of giving Siros be consistent é tht of Csp. Single-dose study in healthy subj.: Csp 175 mg incr. evrol AUC by 168 % (46-365 %) & Cmax by 82 % if given é 2 mg evrol comp. é evrol alone .

Tacrolimus: Alth. Siros & tcrol hv diff. mech. of action, they share the same binding protein (FKBP-12). Initial in vitro rep.: antagonist effect betw. Siros & tcrol. However, because of ubiquitous nature of FKBP-12, in vivo studies of Siros didn’t reveal competitive inhibition. tcrol doesn’t hv the same interactions é Siros as does Csp. In a cross-over study, simultaneous & separate (4 h.) use of Siros & tcrol were compared. No signif. interactions were found in pharmacokinetic parameters including AUC & Cmax .

A unique form of castž 🞜Np. described é DGF & extensive tub. damage é [tcrol + Siros]. Casts were histologically indistinguishable fr. those of myeloma Np.

MMF: study of MMF pharmacokinetic & either Siros or Csp 🠞significant higher AUC for MMF in Siros -ttted ptns if compared to Csp-ttt ptns . Similarly, mycophenolic a. trough conc. were signif. higher in Siros ttted ptn.s. To avoid toxicity, MMF dose reductions is adviced if MMF/Siros combination used.


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Q.707.What are the adverse effects of this group of drugs?
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https://www.fedokidney.com/2020/10/kidney-transplant_67.html
https://www.fedokidney.com/
https://www.fedokidney.com/
https://www.fedokidney.com/2020/10/kidney-transplant_67.html
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