Immunosuppressants

A 28-year-old man with severe systemic lupus erythematosus (SLE) and lupus nephritis (Class IV) is being initiated on induction therapy. Which of the following is the drug of choice for inducing remission in lupus nephritis?

A 45-year-old man with rheumatoid arthritis is initiated on tacrolimus (a calcineurin inhibitor). After 3 weeks of therapy, he develops progressive tremor, headache, and altered mental status. Which investigation is most appropriate to confirm the suspected adverse effect?

Among patients receiving calcineurin inhibitors (cyclosporine or tacrolimus) for organ transplantation, which is the most common dose-limiting toxicity that necessitates drug discontinuation or dose reduction?

A 35-year-old woman with systemic lupus erythematosus (SLE) is started on immunosuppressive therapy. Her nephrologist discusses the mechanisms of action of various immunosuppressants. Which of the following statements about immunosuppressants is NOT true?

A 28-year-old man with renal transplant (post-op day 5) is on triple immunosuppression: tacrolimus, mycophenolate mofetil, and prednisolone. He develops acute rejection (biopsy-confirmed Banff type IIB). Tacrolimus trough level is 8 ng/mL (target 10–15 ng/mL). What is the most appropriate next step in management?