CCTN PHARM Exam Questions with
Correct Solutions
Cyclosporine mechanism of action - ANSWER *Inhibits the first phase of T cell
activation ultimately leading to reduced circulating levels of T cell activators
Cyclosporine Dosing - ANSWER *5-10mg/kg/day PO divided BID
Cyclosporine Drug Levels - ANSWER *1st year: 175-250
*After first year: 100-150
Trough Level of Cyclosporine - ANSWER *100-400 mg/dL
Target usually highest first 6 months post txp
Tacrolimus (Prograf) Dosing: - ANSWER 0.1-0.15mg/kg/day PO divided BID
FK 506 Trough levels - ANSWER *5-15ng/mL
CSA/TAC will obtain a steady state? - ANSWER In 2-3 days
Tacrolimus Mechanism of action: - ANSWER Binds FKBP-12 and inhibits calcineurin and NFAT
activaction
Metabolism/Drug Transport of Tacrolimus and Cyclosporine - ANSWER *Cytochrome P450 3A4
Adverse Effects of CNI's - ANSWER Nephrotoxicity (equal with TAC & Cyclosporine)
*Neurotoxicity (greater with TAC)
Hematologic
, Hyperglycemia
*Hypertension (MOST COMMON SIDE EFFECT) Worse with Cyclosporine
Dermatologic (Cyclosporine-hirsutism/gingival hyperplasia) (TAC-Alopecia)
Gastrointestinal (more with TAC)
Tacrolimus (Prograf) is more likely to result in over cyclosporine? - ANSWER DM
Hypertension
Neurological toxicities
Tacrolimus (Prograf) is less likely to result in over cyclosporine? - ANSWER Hyperlipidemia
Cosmetic problems
Things/Drugs that increase CNI Levels - ANSWER *Antifungals (AZOLES)
Grapefruit/pomegranate juice
*MYCIN antibiotics
Metoclopramide
Simepravir
Diltiazem/verapamil
Protease inhibitors
Fluoxetine
Amiodarone
Drugs that decrease CNIs - ANSWER Cholestyramine
Kayexalate
Octreotide
Probucol
Mg and Al antacids
Correct Solutions
Cyclosporine mechanism of action - ANSWER *Inhibits the first phase of T cell
activation ultimately leading to reduced circulating levels of T cell activators
Cyclosporine Dosing - ANSWER *5-10mg/kg/day PO divided BID
Cyclosporine Drug Levels - ANSWER *1st year: 175-250
*After first year: 100-150
Trough Level of Cyclosporine - ANSWER *100-400 mg/dL
Target usually highest first 6 months post txp
Tacrolimus (Prograf) Dosing: - ANSWER 0.1-0.15mg/kg/day PO divided BID
FK 506 Trough levels - ANSWER *5-15ng/mL
CSA/TAC will obtain a steady state? - ANSWER In 2-3 days
Tacrolimus Mechanism of action: - ANSWER Binds FKBP-12 and inhibits calcineurin and NFAT
activaction
Metabolism/Drug Transport of Tacrolimus and Cyclosporine - ANSWER *Cytochrome P450 3A4
Adverse Effects of CNI's - ANSWER Nephrotoxicity (equal with TAC & Cyclosporine)
*Neurotoxicity (greater with TAC)
Hematologic
, Hyperglycemia
*Hypertension (MOST COMMON SIDE EFFECT) Worse with Cyclosporine
Dermatologic (Cyclosporine-hirsutism/gingival hyperplasia) (TAC-Alopecia)
Gastrointestinal (more with TAC)
Tacrolimus (Prograf) is more likely to result in over cyclosporine? - ANSWER DM
Hypertension
Neurological toxicities
Tacrolimus (Prograf) is less likely to result in over cyclosporine? - ANSWER Hyperlipidemia
Cosmetic problems
Things/Drugs that increase CNI Levels - ANSWER *Antifungals (AZOLES)
Grapefruit/pomegranate juice
*MYCIN antibiotics
Metoclopramide
Simepravir
Diltiazem/verapamil
Protease inhibitors
Fluoxetine
Amiodarone
Drugs that decrease CNIs - ANSWER Cholestyramine
Kayexalate
Octreotide
Probucol
Mg and Al antacids
