Chapter 50 Immunosuppressant Drugs
Sealock Lilley’s Pharmacology for Canadian Health Care Practice
MULTIPLE CHOICE
1. How is cyclosporine (Neoral®) usually given intravenously?
a. In a single intravenous (IV) injectable form to minimize adverse effects
b. Initiated by an oral test dose, then an IV infusion started after 2 hours
c. Diluted and infused with an infusion pump
d. Given as an IV bolus for the first dose, then with an infusion pump for following doses
ANS C
With intravenously administered cyclosporine, the dose must be diluted as recommended by the
manufacturer and given according to the standards of care and institutional policy. Always infuse using
an infusion pump and over the recommended period. Monitor the patient closely during the infusion,
especially during the first 30 minutes, for any allergic reactions. Cyclosporine is not given by using an IV
bolus or with an oral test dose.
DIF Cognitive Level Application
2. A patient about to undergo kidney transplantation will be given azathioprine (Imuran®) to minimize
organ rejection. What important preoperative information should the nurse give the patient about this
drug?
a. Before the surgery, the medication will be administered orally.
b. The oral doses should be taken 1 hour before meals, to maximize absorption.
c. Blood pressure should be monitored for the development of moderate hypertension.
d. For several days before surgery, the patient will need to visit the office daily for intramuscular
(IM) injections.
ANS A
Several days before transplant surgery, immunosuppressant drugs should be taken by the oral route, if
possible, to avoid IM
injections and the risk of infections caused by them.
DIF Cognitive Level Application
, 3. A female patient has started azathioprine (Imuran®) therapy in preparation for her kidney transplant
surgery. Which expected adverse effect of azathioprine therapy should the nurse tell the patient about?
a. Tremors
b. Diarrhea
c. Leukopenia
d. Fluid retention
ANS C
Leukopenia is an expected adverse effect of azathioprine therapy.
DIF Cognitive Level Knowledge
4. Which drug may increase the action of azathioprine (Imuran)?
a. nafcillin b.
rifampin
c. allopurinol
d. phenobarbital
ANS C
Allopurinol may increase the action of azathioprine.
DIF Cognitive Level Knowledge
5. When providing patient education related to immunosuppressive therapy, which items of
information will the nurse include?
a. If a dose is missed, double the next scheduled dose.
b. Take the medication with any type of juice or water.
c. It is important to have a 1-week supply of medication.
d. If the blister-pack pills have an odour, discard them.
ANS C
Tell the patient about the complexity of dosing and about the need to always have a 1-week supply of
medication available so that there is never a risk of running out. If a dose is missed, the patient is to
contact the health care provider. The medication cannot be taken with grapefruit juice. Pills in blister-
packs normally have a characteristic odour.
DIF Cognitive Level Application
Sealock Lilley’s Pharmacology for Canadian Health Care Practice
MULTIPLE CHOICE
1. How is cyclosporine (Neoral®) usually given intravenously?
a. In a single intravenous (IV) injectable form to minimize adverse effects
b. Initiated by an oral test dose, then an IV infusion started after 2 hours
c. Diluted and infused with an infusion pump
d. Given as an IV bolus for the first dose, then with an infusion pump for following doses
ANS C
With intravenously administered cyclosporine, the dose must be diluted as recommended by the
manufacturer and given according to the standards of care and institutional policy. Always infuse using
an infusion pump and over the recommended period. Monitor the patient closely during the infusion,
especially during the first 30 minutes, for any allergic reactions. Cyclosporine is not given by using an IV
bolus or with an oral test dose.
DIF Cognitive Level Application
2. A patient about to undergo kidney transplantation will be given azathioprine (Imuran®) to minimize
organ rejection. What important preoperative information should the nurse give the patient about this
drug?
a. Before the surgery, the medication will be administered orally.
b. The oral doses should be taken 1 hour before meals, to maximize absorption.
c. Blood pressure should be monitored for the development of moderate hypertension.
d. For several days before surgery, the patient will need to visit the office daily for intramuscular
(IM) injections.
ANS A
Several days before transplant surgery, immunosuppressant drugs should be taken by the oral route, if
possible, to avoid IM
injections and the risk of infections caused by them.
DIF Cognitive Level Application
, 3. A female patient has started azathioprine (Imuran®) therapy in preparation for her kidney transplant
surgery. Which expected adverse effect of azathioprine therapy should the nurse tell the patient about?
a. Tremors
b. Diarrhea
c. Leukopenia
d. Fluid retention
ANS C
Leukopenia is an expected adverse effect of azathioprine therapy.
DIF Cognitive Level Knowledge
4. Which drug may increase the action of azathioprine (Imuran)?
a. nafcillin b.
rifampin
c. allopurinol
d. phenobarbital
ANS C
Allopurinol may increase the action of azathioprine.
DIF Cognitive Level Knowledge
5. When providing patient education related to immunosuppressive therapy, which items of
information will the nurse include?
a. If a dose is missed, double the next scheduled dose.
b. Take the medication with any type of juice or water.
c. It is important to have a 1-week supply of medication.
d. If the blister-pack pills have an odour, discard them.
ANS C
Tell the patient about the complexity of dosing and about the need to always have a 1-week supply of
medication available so that there is never a risk of running out. If a dose is missed, the patient is to
contact the health care provider. The medication cannot be taken with grapefruit juice. Pills in blister-
packs normally have a characteristic odour.
DIF Cognitive Level Application
