Case Study 4 – Tacrolimus (Presentation time = 20-25 minutes)
XY is a 50-year-old. 75-kg (height 178cm) male renal transplant patient 2 days after his transplant surgery. His liver functions tests are normal. Suggest an initial oral tacrolimus dose designed to achieve a steady state tacrolimus blood concentration equal to 15 ng/ml. Calculate the peak and trough tacrolimus blood concentrations at steady state.
In your group presentation, you must discuss:
1. The basic pharmacology of tacrolimus (including the mechanism(s) of action and toxicities/adverse effects), its clinical uses and dosages/formulations available.
2. The chemical structure/characteristics of tacrolimus related to its interesting pharmacokinetic characteristics and the clinical implication of these unique features.
3. Considerations that you need to factor in while using tacrolimus in special populations (in renally or hepatically impaired, or in obese patients).
4. Resolve the case study, showing all calculations/steps to determine your answer
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