3.Minimization or avoidance of calcineurin inhibitors after renal transplantation.
Acta Academiae Medicinae Sinicae 2009;31(3):280-283
Calcineurin inhibitors (CNIs) are playing an important role in preventing acute rejection in renal transplantation; however, their nephrotoxicity may impact long-term renal allograft survival. Several CNI-sparing regimens (such as CNI-avoidance or CNI-minimization) have shown at least comparable efficacy with standard-dose CNI regimens. Research continues to achieve the "best" balance between efficacy and toxicity of available immunosuppressive regimens.
Calcineurin Inhibitors
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Graft Rejection
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prevention & control
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Humans
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Immunosuppressive Agents
;
administration & dosage
;
adverse effects
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Kidney Transplantation
4.Appropriate use of immunosuppressants after renal transplantation.
Ye TIAN ; Ze-lin XIE ; Ya-wang TANG ; Wen SUN ; Hong-bo GUO ; Lei ZHANG ; Jun LIN ; Lin-lin MA
Acta Academiae Medicinae Sinicae 2009;31(3):256-258
Kidney transplantation has become an important method in treating advanced renal failure. Immunosuppressants play a key tool in this progress. It is important to understand the goal, mechanism, and adverse effects of immunosuppressive therapy, so as to appropriately use these drugs in post-transplantation patients on a customized basis.
Aftercare
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Humans
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Immunosuppressive Agents
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administration & dosage
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adverse effects
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therapeutic use
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Kidney Transplantation
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Long-Term Care
5.Modified Release Tacrolimus.
M Roy FIRST ; William E FITZSIMMONS
Yonsei Medical Journal 2004;45(6):1127-1131
Modified Release (MR) tacrolimus is an extended release formulation of tacrolimus (Prograf (R) ) administered once daily in the morning. In healthy volunteers, the MR tacrolimus formulation given qd AM and Prograf administered twice daily (bid) have a similar exposure (AUC) and trough levels (Cmin), with a reduced peak level (Cmax). Subsequently, pharmacokinetic studies were performed in stable kidney and liver transplant recipients converted from Prograf bid to MR tacrolimus qd AM. The steady-state tacrolimus exposure and target trough level range of MR tacrolimus were equivalent to Prograf after a mg-for-mg daily dose conversion in these two groups of patients, and there is a high correlation of exposure to trough levels for both Prograf and MR tacrolimus, as well as significantly less intra-subject variability in exposure after conversion to MR tacrolimus. These results indicate that stable kidney and liver transplant recipients can be safely converted from standard Prograf twice daily dosing to the same mg- for-mg daily dose of MR tacrolimus once daily in the morning. Hopefully a once daily dosing regimen of tacrolimus can improve patient compliance while maintaining effective immunosuppression.
Delayed-Action Preparations
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Humans
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Immunosuppressive Agents/*administration & dosage/therapeutic use
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*Kidney Transplantation
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*Liver Transplantation
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Tacrolimus/*administration & dosage/therapeutic use
6.Immunomodulators to be applied with good reason.
Xiao-dong ZHAO ; Xi-qiang YANG
Chinese Journal of Pediatrics 2006;44(6):401-402
10.Pharmacokinetics of mycophenolic acid in Chinese kidney transplant patients.
Xiao-Yang LU ; Hong-Feng HUANG ; Jian-Zhong SHENG-TU ; Jian LIU
Journal of Zhejiang University. Science. B 2005;6(9):885-891
To assess the influence of cyclosporin A (CsA) and tacrolimus (FK506) on mycophenolic acid (MPA) and correlation analysis of the pharmacokinetic parameters and patient characteristics, clinical outcome in Chinese kidney transplant recipients, the pharmacokinetics of 1000 mg mycophenolate mofetil (MMF) twice daily was measured by high-performance liquid chromatography (HPLC). PKS (Pharmaceutical Kinetics Software) 1.0.2 software package was used for the calculation of pharmacokinetic parameters. The mean C(max), t(max), and AUC((0-12))were (21.88+/-10.52) microg/ml, (1.20+/-0.95) h, and (52.546+/-13.215) microg.h/ml, respectively. The level of AUC((0-12)) in the FK506 group was significantly higher than that in the CsA group. MPA appeared not to be affected by renal function. MPA AUC((0-12)) showed statistically significant difference according to the patient's gender.
Adult
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Cyclosporine
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administration & dosage
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Female
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Humans
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Immunosuppressive Agents
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administration & dosage
;
pharmacokinetics
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Kidney Transplantation
;
physiology
;
Male
;
Middle Aged
;
Mycophenolic Acid
;
administration & dosage
;
analogs & derivatives
;
pharmacokinetics
;
Tacrolimus
;
administration & dosage