Pharmacology: Immunosuppressants and Vaccines

Cyclosporine

• Immunosuppressant used in organ transplant recipients and autoimmune diseases.
• Taken at the same time daily.
• Avoid grapefruit juice as it interferes with metabolism.
• Watch for signs of infection like fever, chills, or cough.
• Practice good oral hygiene to prevent gingival hyperplasia.
• Adverse effects include:
  • Hirsutism: usually resolves once medication is stopped.
  • Bone marrow suppression (signs and symptoms include severe infections).
  • Decreased urine output (nephrotoxicity).

Vaccines

• Encourage vaccination based on CDC guidelines
• Immunocompromised patients should avoid live vaccines such as MMR.
• Vaccines are active forms of immunity, a weakened pathogen is introduced creating an immune response.
• Booster shots allow for continued/sustained immunity.

HPV Vaccine

• 2-dose series prior to the 15th birthday, 6 months apart.
• 3-dose series after the 15th birthday.
• Recommended for both male and female patients.
• One of two vaccines that helps prevent cancer.

Hepatitis B Vaccine

• 3-dose series, part of the routine childhood vaccination schedule.
• Reduces the risk of chronic hepatitis, liver cancer, and cirrhosis.

DTaP Vaccine

• 5-dose series, starting at 2 months old.
• Can cause a localized reaction (red, swollen, usually self-limited).
• Prevents Diphtheria, Tetanus, and Pertussis

IPV Vaccine

• 4-dose series.
• Accelerated schedule can be used for out-of-country travel.
• Prevents Polio.

MMR Vaccine

• 2-dose series, starting at 12 months old.
• Live vaccine, should not be used on pregnant people or immunocompromised individuals.
• Protects against measles, mumps, and rubella.

Antibacterial Classes

• Penicillin:
  • Mechanism of action: Inhibits cell wall synthesis.
  • Important to remember: Rash is an adverse effect.
  • Risk of superinfection: Mild risk.
• Cephalosporins
  • Mechanism of action: Inhibits cell wall synthesis.
  • Important to remember: Mostly used for gram-negative infections.
  • Risk of superinfection: Increased risk in later generations.
  • Cross sensitivity: Cross sensitivity is possible with penicillin.
• Tetracyclines
  • Mechanism of action: Inhibits protein synthesis.
  • Important to remember: Causes discoloration of teeth.
  • Risk of superinfection: High risk.
  • No Milk or Iron: Should not be taken with milk or iron.

This quiz covers critical information on cyclosporine, its uses, and important considerations in immunocompromised patients. It also explores vaccination guidelines and specifics regarding the HPV vaccine, aiming to enhance understanding of immunology. Test your knowledge on these essential topics in pharmacology.