CCTC TRANSPLANT PHARMACOLOGY
MIDTERM EXAM WITH COMPLETE
SOLUTIONS | 2025 A+ GRADED
Professor's Name:
Date:
INSTRUCTIONS: Information in BOLD should be added to every exam cover sheet.
1. The length of the examination: If your exam is a take home, please specify the
amount of time (in hours) needed to complete this exam during the stated range of
dates.
2. The number of pages of the examination: Please write how many pages are in the
exam and number each page. For example, "1 of 10, 2 of 10," etc. This is very important
to ensure that exams are duplicated correctly.
3. Indicate what materials may be brought into the examination room (textbook, notes,
casebooks, supplemental materials, etc.) Indicate if no materials are allowed. Usage of
computers should be stated clearly. If your exam will be completed using Exam4
(secure) or MyWCL (non-secure), indicate it here. You do not need to provide
instructions about using Exam4 or MyWCL. The students have already received this
information. You may allow the students the option of handwriting their exams in
bluebooks which will be provided in the exam room.
4. You will receive "0" credit for any unanswered question.
5. If scantron answer sheets are used, give detailed instructions. Only anonymous grading
numbers should be written in the space marked identification number and the
corresponding bubbles should be filled in. If using scantron answer sheets for True and
False questions, please indicate which letter should be used for True and which letter
should be used for False (for example, A=True, B=False). If your exam contains
multiple-choice questions and you do not want to use Scantron answer sheets, describe
how your students should mark their answers (Circle correct answer on the question
sheet, write in a blue book, type them in their document, etc.)
6. No corrections will be made once the exam is distributed. If there is a typo or
ambiguity in a question, state your assumption and answer accordingly.
7. Only your anonymous-grading number should appear on your blue book and
examination copy. DO NOT USE EITHER YOUR NAME OR SOCIAL SECURITY
NUMBER.
8. If you are graduating at the end of the semester, please write "GRADUATING" on
the outside of your exam envelope and on each Blue Book.
9. All materials, including the questions, handwritten answers (if applicable) and
scratch materials at the end of the exam, inserted into your self-sealing exam
envelope and handed to the proctor.
10. The use of electronic devices (iPods, cell phones, mp3 players, etc.) is prohibited
during the exam. This policy is at your discretion, however we recommend this
language to prevent cheating and honor code violations.
, Calcineurin inhibitors - Cyclosporine or Sandimmune (Neoral, Gengraf) &
Tacrolimus or hecoria (Prograf)
MOA of Tacrolimus (Prograf) - binds to fkbp12 to inhibit interleukin 2 production &
release. Which inhibits cytotoxic T cells.
MOA of Cyclosporine (Neoral, Gengraf) - Binds to cyclophylin to inhibit interleukin 2
production & release. Which inhibits cytotoxic T cells.
side effects of tacrolimus - Neurotoxicity (HA, tremors, anxiety, confusion, sleep
disturbance)
Nephrotoxicity
Diarrhea
HTN
Hyperkalemia
Hyperglycemia
Hypomagnesemia
HUS
Hypophosphatemia.
tacrolimus & cyclosporine are synergistic with which meds? - Sirolimus
NSAID'S
how is tacrolimus & Sirolimus metabolized? - Through cytochrome p450 3A4 enzyme
pathway in liver.
How many hours is tacrolimus & cyclosporine troughs? - 11-12 hour trough level.
absorption of tacrolimus & sirolimus - Decreased by food, especially fatty foods.
Best absorbed on empty stomach.
If taken with food, always take with food.
Meds that raise tacrolimus & cyclosporine & Sirolimus trough levels - Macrolide
ABX(erythromycin & clarithromycin).
Diltiazem
verapamil
high dose steroids
azole antifungals
grapefruit (squirt & fresca)
sirolimus
Meds that lower tacrolimus cyclosporine & Sirolimus trough levels - Anti-convulsants
(Dilantin, Phenobarbital, Carbazepine)
Rifampin
Caspofungin
St John's wort.
MIDTERM EXAM WITH COMPLETE
SOLUTIONS | 2025 A+ GRADED
Professor's Name:
Date:
INSTRUCTIONS: Information in BOLD should be added to every exam cover sheet.
1. The length of the examination: If your exam is a take home, please specify the
amount of time (in hours) needed to complete this exam during the stated range of
dates.
2. The number of pages of the examination: Please write how many pages are in the
exam and number each page. For example, "1 of 10, 2 of 10," etc. This is very important
to ensure that exams are duplicated correctly.
3. Indicate what materials may be brought into the examination room (textbook, notes,
casebooks, supplemental materials, etc.) Indicate if no materials are allowed. Usage of
computers should be stated clearly. If your exam will be completed using Exam4
(secure) or MyWCL (non-secure), indicate it here. You do not need to provide
instructions about using Exam4 or MyWCL. The students have already received this
information. You may allow the students the option of handwriting their exams in
bluebooks which will be provided in the exam room.
4. You will receive "0" credit for any unanswered question.
5. If scantron answer sheets are used, give detailed instructions. Only anonymous grading
numbers should be written in the space marked identification number and the
corresponding bubbles should be filled in. If using scantron answer sheets for True and
False questions, please indicate which letter should be used for True and which letter
should be used for False (for example, A=True, B=False). If your exam contains
multiple-choice questions and you do not want to use Scantron answer sheets, describe
how your students should mark their answers (Circle correct answer on the question
sheet, write in a blue book, type them in their document, etc.)
6. No corrections will be made once the exam is distributed. If there is a typo or
ambiguity in a question, state your assumption and answer accordingly.
7. Only your anonymous-grading number should appear on your blue book and
examination copy. DO NOT USE EITHER YOUR NAME OR SOCIAL SECURITY
NUMBER.
8. If you are graduating at the end of the semester, please write "GRADUATING" on
the outside of your exam envelope and on each Blue Book.
9. All materials, including the questions, handwritten answers (if applicable) and
scratch materials at the end of the exam, inserted into your self-sealing exam
envelope and handed to the proctor.
10. The use of electronic devices (iPods, cell phones, mp3 players, etc.) is prohibited
during the exam. This policy is at your discretion, however we recommend this
language to prevent cheating and honor code violations.
, Calcineurin inhibitors - Cyclosporine or Sandimmune (Neoral, Gengraf) &
Tacrolimus or hecoria (Prograf)
MOA of Tacrolimus (Prograf) - binds to fkbp12 to inhibit interleukin 2 production &
release. Which inhibits cytotoxic T cells.
MOA of Cyclosporine (Neoral, Gengraf) - Binds to cyclophylin to inhibit interleukin 2
production & release. Which inhibits cytotoxic T cells.
side effects of tacrolimus - Neurotoxicity (HA, tremors, anxiety, confusion, sleep
disturbance)
Nephrotoxicity
Diarrhea
HTN
Hyperkalemia
Hyperglycemia
Hypomagnesemia
HUS
Hypophosphatemia.
tacrolimus & cyclosporine are synergistic with which meds? - Sirolimus
NSAID'S
how is tacrolimus & Sirolimus metabolized? - Through cytochrome p450 3A4 enzyme
pathway in liver.
How many hours is tacrolimus & cyclosporine troughs? - 11-12 hour trough level.
absorption of tacrolimus & sirolimus - Decreased by food, especially fatty foods.
Best absorbed on empty stomach.
If taken with food, always take with food.
Meds that raise tacrolimus & cyclosporine & Sirolimus trough levels - Macrolide
ABX(erythromycin & clarithromycin).
Diltiazem
verapamil
high dose steroids
azole antifungals
grapefruit (squirt & fresca)
sirolimus
Meds that lower tacrolimus cyclosporine & Sirolimus trough levels - Anti-convulsants
(Dilantin, Phenobarbital, Carbazepine)
Rifampin
Caspofungin
St John's wort.
