The nurse is caring for a patient after recent renal transplantation. The patient is taking sirolimus (Rapamune) to prevent transplant rejection. What other medications would the nurse expect the patient to be taking?
a. Rifampin and ketoconazole
b. Carbamazepine and phenobarbital
c. Cyclosporine and glucocorticoids
d. Amphotericin B and erythromycin
ANS: C
Sirolimus should be used in conjunction with cyclosporine and glucocorticoids to reduce the risk of transplant rejection. Rifampin can reduce and ketoconazole can increase therapeutic levels of sirolimus and cyclosporine; therefore, they are not indicated for transplant patients. Carbamazepine and phenobarbital are not indicated, because they can reduce the therapeutic levels of sirolimus and cyclosporine. Amphotericin B and erythromycin are not indicated, because they can increase the therapeutic levels of sirolimus and cyclosporine.
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