Ciclosporin Flashcards
(20 cards)
What is the therapeutic range of ciclosporin?
Depends on clinical situation and indication for treatment
Loading doses may be required based on the patient’s needs.
What monitoring is required for ciclosporin therapy?
Full blood count, liver function, serum electrolytes (K*, Mg?:), blood lipids, renal function (including creatinine, urea), blood pressure, dermatological and physical examination
Regular monitoring helps in identifying potential side effects and adjusting treatment.
What are some warning signs of neurotoxicity associated with ciclosporin?
Tremor, headache, encephalopathy (e.g. confusion, convulsions)
Neurotoxicity can lead to serious complications if not addressed promptly.
What blood disorders may indicate toxicity from ciclosporin?
Leucopenia, thrombocytopenia, signs of infection such as fever, sore throat, mouth ulcers, unexplained bruising or bleeding
Monitoring for blood disorders is crucial to prevent severe complications.
What are the signs of liver toxicity from ciclosporin?
Jaundice, nausea, vomiting, abdominal discomfort, dark urine
Early identification of liver toxicity can prevent irreversible damage.
What renal toxicity sign should be monitored in patients taking ciclosporin?
Elevated serum creatinine concentrations
Regular renal function tests are essential to manage and adjust treatment.
List some other signs of toxicity from ciclosporin.
- Vomiting
- Drowsiness
- Tachycardia
- Hypertension
- Headache
- Gingival hyperplasia
Recognizing these signs can lead to timely intervention.
What actions should be taken if warning signs occur in a patient taking ciclosporin?
Advise patient to report immediately to a doctor
Prompt reporting can be vital for patient safety.
What is a common side effect of ciclosporin therapy?
Hypertension
Regular blood pressure monitoring is essential for patients on ciclosporin.
What immunization should patients on ciclosporin avoid?
Live vaccines
Immunosuppression from ciclosporin increases the risk of vaccine-related infections.
What dietary considerations should be advised for patients taking ciclosporin?
Avoid excessive exposure to UV light, high potassium diet, and grapefruit juice
These dietary adjustments can mitigate the risk of adverse effects.
What should be done when changing brands of ciclosporin?
Monitor closely for changes in ciclosporin level, serum creatinine, and blood pressure
Brand-specific prescribing is recommended to ensure consistent drug levels.
Which medications can increase plasma concentration of ciclosporin?
- Clarithromycin
- Diltiazem
- Erythromycin
- Fluconazole
- Grapefruit juice
- Itraconazole
- Ketoconazole
- Miconazole
- Metoclopramide
- Verapamil
- Colchicine (increased risk of nephrotoxicity and myotoxicity)
- Tacrolimus (avoid)
Careful management of drug interactions is crucial for patient safety.
Which medications can decrease plasma concentration of ciclosporin?
- Carbamazepine
- Orlistat
- Phenobarbital
- Phenytoin
- Rifampicin
- St. John’s Wort
Monitoring is necessary to adjust dosages accordingly.
What is the effect of ciclosporin when given with ACE inhibitors or angiotensin-II receptor antagonists?
Increased risk of hyperkalaemia
Hyperkalaemia is a condition characterized by elevated levels of potassium in the blood, which can lead to serious heart complications.
What is the risk associated with the concomitant use of ciclosporin and NSAIDs?
Increased risk of nephrotoxicity
Nephrotoxicity refers to the damage to the kidneys caused by drugs or toxins.
What effect does ciclosporin have on the plasma concentration of diclofenac?
Increased plasma concentration of diclofenac
Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID) used for pain relief.
What is the consequence of ciclosporin on digoxin levels?
Ciclosporin increases plasma concentration of digoxin
Digoxin is a medication used to treat various heart conditions, and increased levels can lead to toxicity.
What is the risk of myopathy when ciclosporin is used with statins?
Increased risk of myopathy
Myopathy refers to muscle weakness or pain, and statins are commonly prescribed to lower cholesterol levels.
Which statins should be avoided when using ciclosporin?
Atorvastatin, fluvastatin, pravastatin, rosuvastatin, simvastatin
These statins are used to manage cholesterol levels but have a risk of causing myopathy when combined with ciclosporin.
