Author Question: The nurse is caring for a patient who recently receive a renal transplant. The patient is taking ... (Read 88 times)

formula1 · **on:** Jul 23, 2018

The nurse is caring for a patient who recently receive a renal transplant. The patient is taking sirolimus (Rapamune) to prevent transplant rejection. What other medications would the nurse expect the patient to be taking?

a. Rifampin and ketoconazole
b. Carbamazepine and phenobarbital
c. Cyclosporine and glucocorticoids
d. Amphotericin B and erythromycin

Question 2

Which drug, when given concurrently with cyclosporine (Sandimmune), can inhibit hepatic microsomal enzymes and lead to toxic levels of cyclosporine?

a. Phenytoin (Dilantin)
b. Rifampin (Rifadin)
c. Erythromycin
d. Trimethoprim-sulfamethoxazole (Bactrim)

trampas · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: C
Sirolimus should be used in conjunction with cyclosporine and glucocorticoids to reduce the risk of transplant rejection.
Rifampin can reduce and ketoconazole can increase therapeutic levels of sirolimus and cyclosporine, therefore they are not indicated for transplant patients.
Carbamazepine and phenobarbital are not indicated, because they can reduce the therapeutic levels of sirolimus and cyclosporine.
Amphotericin B and erythromycin are not indicated, because they can increase the therapeutic levels of sirolimus and cyclosporine.

Answer to Question 2

ANS: C
Erythromycin can elevate microsomal enzymes, leading to increased levels of cyclosporine.
Phenytoin, rifampin, and trimethoprim-sulfamethoxazole reduce the levels of cyclosporine in the body.