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>>Your immune system protects you by
fighting infections and foreign bodies. Your immune system will recognize
a newly transplanted organ as a foreign body, and will fight against it. Medications called immunosuppressive
drugs are used to prevent your body from rejecting your newly transplanted organ. You will need to take immunosuppressive
medications for your lifetime. These medications are very expensive, costing
between 2,000 and 4,000 dollars every month. You will need to work with your financial
coordinator to develop a sound insurance and financial plan to cover
the cost of these medications. As a transplant recipient, you will
begin taking new medications the day of or the day after your transplant. You will take medications to prevent rejection, to prevent infection, and
other medications as well. You will need to take some combination of
medications for the remainder of your life, or your transplanted organ will fail. All medications have possible side effects. Here is a list of side effects associated
with your transplant medications. You are not likely to have all the side
effects, or have them all at a high intensity. If you have any concerns
about your side effects, you should discuss your concerns
with your transplant nurse. Many of the medications must
be tapered, or slowly reduced. Do not independently withdraw
from taking any medication. Discuss any concerns you have with
your transplant nurse or physician. To prevent rejections, you will take
a combination of three medications after surgery — Prednisone, which is a
steroid; azathioprine, also known as Imuran; or mycophenolic, also known as
CellCept; tacrolimus, or cyclosporine. The exact combination of these drugs will
be determined by the transplant team. Due to their anti-inflammatory
and immunosuppressive properties, steroids have been the main component in the
immunosuppressive regimen for the prevention and treatment of acute rejection
after lung transplantation. Prolonged exposure to steroids
result in significant side effects, which include worsening cholesterol
levels and high blood pressure, the development of post-transplant diabetes
mellitus, weight gain, and osteoporosis. Our standard protocol is designed
to minimize these effects, by keeping the maintenance steroid dosage low. Azathioprine, or Imuran, mycophenolic,
mofatile, or CellCept, and mycophenolate sodium, or myfortic, are medications used in
combination with tacrolimus or cyclosporine. Azathioprine is known to cause
liver function abnormalities, low blood counts, and pancreatitis. The main toxicities of mycophenolate
are upset stomach and diarrhea. Cyclosporine and tacrolimus can
cause abnormal kidney function, high blood sugar, tremors, and headaches. These medications could cause serious
harm to a fetus if taken while pregnant. Therefore, women of child-bearing ages should
avoid pregnancy for the rest of their lives. If you have any questions regarding
these medications, or pregnancy, please discuss it with your
transplant coordinator or physician. Anti-fungal and anti-viral
medications are administered to prevent infection after transplant. These are very expensive medications, each one
costing approximately 2,000 dollars a month. These medications are usually covered
by insurance, but carry high co-pays. Because of the side effects of
your transplant medications, you may require additional medications to
treat high blood pressure and high blood sugar. Do not take any non-steroidal
anti-inflammatory drugs or NSAIDs. These include Aleve, Advil,
Motrin, or Ibuprofen. These medications are too hard on
your kidneys, and should be avoided. Avoid eating grapefruits and drinking
grapefruit juice, due to numerous interactions with your transplant medications. Do not go to the dentist for six
months after your transplant operation. To reduce the risk of developing an infection, you will need to take an antibiotic
before any dental work is done, including routine cleanings. You must learn about each of your new
medications before you can be discharged from the hospital. You will need to know the drug name, the
purpose of the medication, the side effects, and the dosages of each medication. The nursing staff will work
with you and your care giver to develop a self-medication schedule. Your support person must participate
in learning about your medications. To ensure you can safely manage
your own medications at home, you and your support person will be
quizzed to demonstrate your knowledge about your medications prior to discharge. [ Silence ]

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