Module 11 - Case Study Flashcards Preview

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Flashcards in Module 11 - Case Study Deck (6)
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1
Q

What is the mechanism of action of tracrolimus? How does it prevent graft rejection?

A

Tacrolimus is an immunosuppressant drug which reduces T-cell proliferation and cytokine production.
This serves to prevent transplant rejection.

2
Q

What does an increase in serum creatinine suggest?

A

Creatinine is a normal metabolic product of muscles, which is cleared by the kidneys.
Accumulation suggests kidney impairment.

3
Q

What drug suggested by Dr. Phil could hav accounted for a drug interaction?

A

St. John’s wort - used to treat depression also induces CYP3A4 - which metabolizes tacrolimus.
Also, St. john’s wort can interact with anxiolytic lorazepam and cholesterol lowering rosuvastatin
This combination can lead to kidney damage

4
Q

What is the significance of the delay in reaction from when Tracy began taking the drugs to when his tacrolimus concentration began to drop?

A

Enzyme induction is a delayed process, and as such, it would take 2-10 days before the effects of enzymatic induction manifested.

5
Q

Why is Tracey experiencing these symptoms?

A

The lack of excretion of drugs and toxins by the kidneys.

Excessive drinking also has negative effects on kidney function.

6
Q

What should be done to save Tracy?

A

The use of St. John’s Wort should be discontinued.