Immunosuppressant Drugs in Pregnancy

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Is something missing in your life?  Is it the opportunity to take multiple-choice exams?  If so, check out this 10-question ASN-sponsored practice test designed to prepare Nephrology Fellows to be ready for the upcoming Nephrology Boards in November.  You can cut & paste the link is here since I’m having some problems embedding it for some reason:
www.asn-online.org/ite 
Quick teaching point I picked up from the exam:  reviewing the management of immunosuppressant drugs in the kidney transplant patient who is pregnant.  
CNI’s (cyclosporine & tacrolimus) are okay, as are steroids and azathioprine.  The two main drugs to watch out for are MMF (Cell Cept), which is a known teratogen in animal studies, and sirolimus (rapamycin) which is a suspected teratogen.  Kidney transplant patients who are on either Cell Cept or rapamycin should have these agents switched to a safer immunosuppressant (e.g., azathioprine) if they are considering pregnancy.  

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