Overview Snapshot A 36-year-old woman presents to the emergency department with worsening weakness and decreased visual acuity of the right eye. She reports that her symptoms progressively worsened over the course of a week and after developing an upper respiratory infection. Medical history is significant for multiple sclerosis (MS) treated with rituximab. Physical examination is significant for 2/5 strength in the lower extremities and an afferent pupillary defect appreciated in the right eye. Magnetic resonance imaging of the brain and spine shows new enhancing lesions when compared to prior imaging. After further evaluation, it was determined she had an MS exacerbation. She is started on intravenous methylprednisolone. Immunosuppressants Immunosuppressants Medication Clinical Use Mechanism of Action Adverse Effects Cyclosporine Rheumatoid arthritis Psoriasis Transplant rejection prophylaxis Calcineurin inhibitor which impairs IL-2 production and release impairs IL-2-induced T-cell activation Nephrotoxicity Neurotoxicity Hirsutism Gingival hyperplasia Hypertension Hyperlipidemia Tacrolimus (FK506) Transplant rejection prophylaxis Calcineurin inhibitor via binding with intracellular FKBP-12 protein which impairs IL-2 production and release impairs IL-2-induced T-cell activation Nephrotoxicity Neurotoxicity ↑ risk of diabetes Sirolimus (Rapamycin) Lymphangioleiomyomatosis Renal transplantation prophylaxis mTOR inhibitor via binding with intracellular FKBP-12 protein which ↓ cytokine-induced T-cell proliferation Pancytopenia Hyperlipidemia Edema Insulin resistance Basiliximab Renal transplantation prophylaxis Targets the α-chain of the IL-2 receptor complex which is expressed on activated T-cells Edema Tremor Hypertension Azathioprine Rheumatoid arthritis Renal transplantation Inflammatory bowel disease A precursor of 6-mecaptopurine which inhibits purine nucleotide synthesis incorporates itself into the cell's DNA and halts replication Pancytopenia Mycophenolate mofetil Organ transplantation Lupus nephritis Inosine monophosphate dehydrogenase (IMPDH) inhibitor which impairs guanosine nucleotide synthesis Gastrointestinal upset Pancytopenia Hypertension Corticosteroids A number of autoimmune and inflammatory disorders NF-κB inhibitor Induces T-cell apoptosis Hyperglycemia Osteoporosis Cushing syndrome Adrenocortical atrophy Peptic ulcers Cataracts Avascular necrosis Psychosis
QUESTIONS 1 of 8 1 2 3 4 5 6 7 8 Previous Next Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (M1.IM.13.59) A 31-year-old female receives a kidney transplant for autosomal dominant polycystic kidney disease (ADPKD). Three weeks later, the patient experiences acute, T-cell mediated rejection of the allograft and is given sirolimus. Which of the following are side effects of this medication? QID: 101013 Type & Select Correct Answer 1 Nephrotoxicity, hypertension 12% (39/320) 2 Pancreatitis 7% (22/320) 3 Hyperlipidemia, thrombocytopenia 55% (177/320) 4 Cytokine release syndrome, hypersensitivity reaction 9% (29/320) 5 Nephrotoxicity, gingival hyperplasia 13% (42/320) M 3 Question Complexity E Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 3 Review Tested Concept Review Full Topic Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK
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