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Immunosuppression Case Study

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Immunosuppression (Nico)

There are currently two kinds of immunosuppressive therapy being practiced, they are induction and maintenance therapy. Induction therapy is the intensive immunosuppressive therapy given perioperatively to reduce the risk of acute rejection (Scheffert & Raza, 2014). Maintenance therapy on the other hand is the long term or lifelong immunosuppressive treatment regimen. Both of these immunosuppressive methods are used to reduce the risk of organ rejection.

A common variation of maintenance immunosuppression is called “triple therapy”. It is a pharmacologic method of suppressing the immune system of a patient that has undergone organ transplantation. This treatment regimen is designed to maximize the
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In addition, cyclosporine trough levels should also be monitored to detect possible cyclosporine toxicity. As with all immunosuppressive drugs, taking cyclosporine severely hampers the patient’s immune system. It is important to educate the patient on the signs and symptoms of infection and/or lung transplant rejection (i.e. fever, severe headaches, persistent nausea and vomiting, edema, shortness of breath, dyspnea, and chest pain). It also important to inform the patient to avoid certain foods and medications like grapefruit and St. John’s Wort (Kizior R., Kizior B., Hodgson, & Whitmer, 2017). Mycophenolate Mofetil
Mycophenolate is an immunosuppressant used concurrently with cyclosporine and corticosteroids. It has taken the place of azathioprine in heart and lung transplant triple therapy because it is more effective in reducing acute allograft rejection when compared to azathioprine (Whitson, 2017). This drug works by inhibiting inosine monophosphate dehydrogenase -an enzyme that stops B and T lymphocyte proliferation. This decrease in lymphocytes causes a decrease in immune response. Mycophenolate Mofetil is usually ordered at 1 g PO bid; the dose is titrated to maintain WBC levels above 4000 cells/mm3. Trough concentrations of 12-15 ng/dL are usually
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