Prototype Drug 5 & 7- Cyclosporine

Question 1

Therapeutic classification

Answer 1

Immunosuppressant

Question 2

Pharmacologic classification

Answer 2

Calcineurin inhibitor

Question 3

Therapeutic effects and uses

Answer 3

Prophylaxis of the kidney, heart and liver transplant rejection; psoriatsis; severe RA; and xerophthalmia, an eye condition of diminished tear production caused by ocular inflammation
Off-label: autoimmune and inflammatory conditions such as ulcerative colitis, SLE, mayshenia gravis, aplastic anemia, Crohn’s disease, psoriatic arthritis, and graft-versus-host disease.
Often used with corticosteroid such as prednisone

Question 4

Mechanism of Action

Answer 4

Inhibits the fuction of calcineurin. This diminshes the activity of T cells and B cells and suppresses the immune response

Question 5

Adverse effects

Answer 5

Nephrotoxicity, HTN and tremor, Hirsutism, elevated hepatic enzymes, headache, and gingival hyperplasia. Infections are common such as reactivation of latent herpes or varicella infections. Anaphylaxis is also reported when taken IV. Long-term= risk of malignancy

Question 6

Black Box Warning

Answer 6

Serious infection and possible malignancies. Renal function should be monitored

Question 7

Contraindications/Precautions

Answer 7

Should not be directly exposed to sun light, have renal impairment, pregnant, lactating, have infections (should be treated before therapy)

Question 8

Drug interactions

Answer 8

Don’t take with phenytoin, phenobarbital, carbamazepine, and rifampin. Potassium sparing diuretic should be avoided because they can cause hyperkalemia. Statins should not be used with it because it can cause myopathy or rhabdomyolysis

Question 9

Herbal/food interactions

Answer 9

Food decreases absorption
Grapefruit juice raises levels of drug
Astragalus and echinacea interferes with the action of immunosuppressants