Overview of transplantation immunology and the pharmacotherapy of adult solid organ transplant recipients: focus on immunosuppression.
A review of transplantation immunology is discussed with emphasis on alloantigen presentation, T-lymphocyte activation and proliferation, and the immune effector mechanisms responsible for allograft rejection. Immunosuppressive pharmacology is introduced beginning with conventional medications (cyclosporine, azathioprine, and corticosteroids) followed by a discussion of drugs recently approved by the US Food and Drug Administration (mycophenolate mofetil, tacrolimus, and the interleukin-2 receptor antagonists). In addition, drugs that are used in the treatment of transplant rejection or as rescue therapy are discussed (muromonab-CD3, antithymocyte globulin, mycophenolate mofetil, tacrolimus, and corticosteroids). Throughout, implications for nurses involved in the pharmacotherapy of transplant recipients are discussed.
Bush
W W
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Department of Pharmacy Services, University Hospitals of Cleveland, OH 44106, USA.
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001379:Azathioprine / Q000627:therapeutic use; D016572:Cyclosporine / Q000627:therapeutic use; D004347:Drug Interactions; D016903:Drug Monitoring / Q000379:methods / Q000451:nursing; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control*; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects / Q000379:methods* / Q000451:nursing; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016853:Muromonab-CD3 / Q000627:therapeutic use; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D015375:Receptors, Interleukin-2 / Q000037:antagonists & inhibitors; D013256:Steroids; D016559:Tacrolimus / Q000627:therapeutic use; D014181:Transplantation Immunology
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D016853:Muromonab-CD3; D015375:Receptors, Interleukin-2; D013256:Steroids; D016572:Cyclosporine; D009173:Mycophenolic Acid; D001379:Azathioprine; D016559:Tacrolimus