Page 1906 - Saunders Comprehensive Review For NCLEX-RN

and T lymphocytes.

2. Can cause neutropenia and thrombocytopenia

from bone marrow suppression
3. Contraindicated in pregnancy; associated with an
increased incidence of neoplasms
4. Monitor hematocrit, white blood cell count, platelet
count, liver enzyme levels, and coagulation factors.
H. Mycophenolate mofetil
1. Mycophenolate mofetil causes selective inhibition of
B- and T-lymphocyte proliferation.
2. May be used with cyclosporine or tacrolimus and
glucocorticoids for prophylaxis against organ
rejection

3. Adverse effects include diarrhea, severe

neutropenia, vomiting, and sepsis.
4. Mycophenolate mofetil is associated with an increased
risk of infection and malignancies.
5. Absorption is decreased by the use of magnesium and
aluminum antacids and by cholestyramine.
6. It is contraindicated in pregnancy and during breast-
feeding.
7. Instruct the client to take the medication on an empty
stomach and not to open or crush capsules.
8. Instruct the client to contact the PHCP for unusual
bleeding or bruising, sore throat, mouth sores,
abdominal pain, or fever.

Persons who have undergone organ transplant, such as a

kidney, must take the prescribed immunosuppressant medications at
the same time each day to ensure that the immune system is sufficiently
suppressed to prevent organ rejection.
I. Basiliximab
1. Basiliximab binds to interleukin-2 receptors on
lymphocytes, resulting in diminished cell-mediated
immune reactions.
2. Used primarily as an induction agent at the time of
transplantation; may be used with other
immunosuppressants to prevent acute rejection of
transplanted kidneys
3. Administered by the IV route; initial dose is
administered within 2 hours before transplantation.
4. Side and adverse effects include headache, insomnia,
dizziness, and tremors; chest pain, gastrointestinal
distress, edema, shortness of breath, pain in the joints,

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