Tacrolimus
CPT4 code
Name of the Procedure:
Tacrolimus Administration
Common names: Tacrolimus, FK506
Medical term: Tacrolimus Drug Therapy
Summary
Tacrolimus is an immunosuppressive medication primarily used to prevent organ rejection after a transplant. It helps the body's immune system from attacking the transplanted organ. It can be administered orally or intravenously.
Purpose
Addressed Condition: Tacrolimus is used to prevent rejection in patients who have received liver, kidney, or heart transplants.
Goals/Outcomes: The main goal is to maintain the health and function of the transplanted organ by preventing the immune system from rejecting it.
Indications
Specific Symptoms/Conditions: Patients who have undergone organ transplants (liver, kidney, heart) and are at risk for organ rejection.
Patient Criteria: Suitable for patients who are capable of adhering to a medication schedule and can manage potential side effects.
Preparation
Pre-Procedure Instructions: Patients should inform their healthcare provider of all medications they are taking. Blood tests may be required to establish baseline kidney and liver function, and to determine appropriate dosing.
Diagnostic Tests: Kidney and liver function tests, blood pressure checks, and baseline blood levels.
Procedure Description
- Oral Administration:
- Tacrolimus is taken as a capsule or extended-release tablet.
- It should be taken on an empty stomach or at least 1 hour before or 2 hours after a meal.
Intravenous Administration (for those unable to take orally):
- Administered through an IV drip, typically over 24 hours, in a hospital setting.
Tools/Equipment: Pills or intravenous (IV) drip setup for hospital use.
Anesthesia/Sedation: Not applicable.
Duration
Oral: Ongoing daily administration.
IV: Continuous 24-hour administration until oral intake is possible.
Setting
Oral: At home, under regular monitoring.
IV: Hospital inpatient setting.
Personnel
Healthcare Professionals Involved: Transplant surgeons, nephrologists/hepatologists/cardiologists, nurses, and pharmacists.
Risks and Complications
Common Risks: Increased susceptibility to infections, hypertension, kidney damage, diabetes, neurotoxicity (e.g., tremors, headaches).
Rare Risks: Malignant conditions (e.g., lymphoma), severe allergic reactions.
Management: Careful dosing, regular blood tests, and monitoring adverse reactions.
Benefits
Expected Benefits: Prevention of organ rejection and prolonged function of the transplanted organ.
Realization Time: Immediate effects in organ protection with long-term benefits as long as the medication is taken regularly.
Recovery
Post-Procedure Care: Regular blood tests to monitor drug levels and organ function, blood pressure monitoring, lifestyle modifications to reduce infection risk.
Expected Recovery Time: Long-term, in terms of preventing organ rejection.
Restrictions/Follow-ups: Regular follow-ups with transplant specialists and routine medical evaluations.
Alternatives
Other Treatment Options:
- Cyclosporine
- Mycophenolate mofetil
- Corticosteroids Pros and Cons: Tacrolimus is often preferred due to better efficacy and fewer cosmetic side effects compared to alternatives, but alternatives might be used in case of specific side effects or contraindications.
Patient Experience
During the Procedure: Oral administration involves taking medication daily; IV administration requires being in the hospital.
Post-Procedure Feelings/Experience: Patients may experience side effects like tremors, headaches, or digestive issues. Regular blood tests may be uncomfortable.
Pain Management/Comfort Measures: Over-the-counter pain relief for side effects, regular consultation for managing other symptoms.