Nursing Protocol

Understanding MELD by Sue Johanson, PharmD Candidate

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Glucocorticosteroid: A Review by Rahel Woldo PharmD

Rahel Woldu, PharmD
University of Colorado Health Sciences Center
September 9, 2003

Introduction (1,2)
• It is estimated that more than 5 million patients are treated with GCs annually.
• The anti-inflammatory and immunosuppressive effects of steroids have been exploited in the treatment of diseases such as; bronchial asthma, chronic obstructive pulmonary disease, rheumatoid arthritis, collagen vascular diseases, chronic active hepatitis and certain forms of nephritides.

Muromonab-CD3 (OKT-3) by Kimberly Fischer, RN BSN

Muromonab-CD3 is a mouse antibody produced from fusion of mouse plasma cells with human B-cell myeloma cells, targeting human T-cell CD-3. This mouse IgG2a was first approved in 1986 by FDA to be used in organ transplant rejection. It coats or binds to CD-3, T-cell surface proteins, subjecting OKT-3/CD-3 complex to opsonization by the reticuloendothelial system in the liver with the first dose. The first dose of OKT-3 cause massive activation and subsequent depletion of oT-helper cells within the first day.

Tacrolimus: Nursing Considerations

Special Nursing Considerations
Food-Drug Interactions.
Tacrolimus should be taken consistently either with or without meals.
Fat meal appears to reduce drug exposure by 40%.
Avoid grapefruit juice;increase levels by reducing
metabolism by liver & gut enzymes
Drug-Drug Interactions
Drugs that increase levels:erythromycin, itraconazole,fluconazole, ketoconazole, diltiazem, methylprednisolone, methyltestosterone, warfarin, imipenem/cilistatin, verapamil, metoclopramide, nicardipine, prednisolone, levonorgestrel

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