Page 28 - RxExam's Naplex Theory Book Part 2

www.pharmacyexam.com Krisman

Dose Special Notes

Lymphocyte 1. Renal 2). Before the first infusion of Lymphocyte immune globulin,
Immune Transplant: Pharmacia & Upjohn Company strongly recommends that patients be
Globulin tested with an intradermal injection of 0.1 mL of a 1:1,000 diluted
(Injection) a). Delaying the Lymphocyte immune globulin. A systemic reaction to the injection
Onset of Allograft such as a generalized rash, tachycardia, dyspnea, hypotension, or
Rejection anaphylaxis precludes any additional administration of Atgam.
Give a fixed dose of
15 mg/kg daily for 3). Adding Atgam to dextrose injection is not recommended, as low
14 days, then every salt concentrations can cause precipitation. Highly acidic infusion
other day for 14 solutions can also contribute to physical instability over time. It is
days for a total of recommended that diluted Atgam be stored in a refrigerator if it is
21 doses in 28 days. prepared prior to the time of infusion. Even if it is stored in a
Give the first dose
within 24 hours refrigerator, the total time in dilution should not exceed 24 hours
before or after the (including infusion time).
transplant.
4). Arthralgia; chest or back pain, or both;, diarrhea; dyspnea;
b). Treatment of headache; hypotension; nausea or vomiting, or both; night sweats;
Rejection pain at the infusion site; thrombocytopenia; peripheral
The first dose of thrombophlebitis; and stomatitis are reported side effects of
can be delayed Lymphocyte immune globulin.
until the diagnosis
of the first 5). A physician should discontinue treatment with Atgam if any of the
rejection episode. following occurs:
Give a 10 to 15 1. Symptoms of anaphylaxis.
mg/kg daily for 14 2. Severe and unremitting thrombocytopenia in renal transplant
days. Additional patients.
alternate-day 3. Severe and unremitting leukopenia in renal transplant patients.
therapy up to a
total of 21 doses
can be given.

2. Aplastic
anemia:
10 to 20 mg/kg
daily for 8 to 14
days. Additional
alternate-day
therapy up to a
total of 21 doses
can be given.

Belatacept 1). Renal 1). Belatacept (Nulojix), a selective T-cell (lymphocyte) costimulation
(Injection) Transplant: blocker, binds to CD80 and CD86 on antigen-presenting cells thereby
Initial: 10 mg/kg blocking CD28 mediated costimulation of T lymphocytes. It inhibits T
Maintenance: 5 lymphocyte proliferation and the production of the cytokines
mg/kg interleukin-2, interferon-β, interleukin-4, and TNF-α.

27