Anti-inflamm Antiallergic Immunologic Drugs- pharm

68 1 sites of action of immunosuppressant drugs

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Unformatted text preview: autoimmune diseases Toxicity – Increased risk of infection – Increased risk of neoplasms Fig. 68-1. Sites of action of immunosuppressant drugs. Calcineurin Inhibitors Calcineurin Cyclosporine (Sandimmune) and Cyclosporine tacrolimus (Prograf)– most effective tacrolimus immunosuppressants available immunosuppressants Differ in structure, but share same Differ mechanism mechanism Both inhibit calcineurin and thereby Both suppress production of interleukin-2 suppress Cyclosporine (Sandimmune) Cyclosporine Mechanism – To suppress the production of interleukin-2, To interferon gamma, and other cytokines interferon Uses – Drug of choice for organ rejection (kidney, Drug liver, and heart) of an allogenic transplant liver, – Some autoimmune diseases Cyclosporine (Sandimmune) Cyclosporine Adverse effects – Nephrotoxicity – Infection – Hepatotoxicity – Lymphoma – Hypertension – Tremor – Hirsutism – Leukopenia, gingival hyperplasia, Leukopenia, gynecomastia, sinusitis, hyperkalemia gynecomastia, – Anaphylactic reactions Cyclosporine (Sandimmune) Cyclosporine Drug and food interactions – Drugs that can decrease cyclosporine levels – Drugs that can increase cyclosporine levels – Nephrotoxic drugs – Grapefruit juice Tacrolimus (Prograf) Tacrolimus An alternative to cyclosporine Somewhat more effective – but also more toxic Concurrent use with glucocorticoids Therapeutic use – Prophylaxis of organ rejection (liver, kidney, or heart) Prophylaxi...
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