Single 44pc i in patient with acute myocardial infarction definition psycho pouring is an immunosuppressant drug widely used in olin transportation to prevent reject it reduced activity of immune system by interfering with activity and growth of t cells for a next video electron immunosuppressant drugs we’ll be looking at primarily cyclosporine a but also a little
Bit at tacrolimus or fk506 due to the fact that they both have an overlapping mechanism of action both of these drugs are used primarily for prevention of organ rejection post-transplantation and the really interesting thing is that both of these drugs are very much structurally different cyclosporine a is a fungal metabolite whereas technol ignis is a map bulid
Now normally what happens is we have an antigen presenting cells such as a macrophage or dendritic cell which presents an antigen through an mhc marker and binds on to a t-cell receptor and also a cd20 receptor leading to activation of calcineurin which is a serine threonine phosphatase that dephosphorylates and fat allowing it to transfer kit into the nucleus
And lead to transcription of genes that lead to production of il-2 il-2 is a very important cytokine that leads to clonal expansion of t-cells the way in which these drugs work is twofold for fk506 or tackle em is it binds on to fk binding protein and for cyclosporine a it binds out to cycle for one cycle of fillin and fk binding protein inhibit calcineurin by
Inhibiting calcineurin it can no longer dephosphorylate n plan and therefore in fact cannot translocate into the nucleus in need to expression of il-2 it is important to note that even though here i only show that these drugs inhibit the pathway that leads to increased synthesis of il-2 that these drugs will also lead to decreased senses to necrosis factor-alpha
Also decreased synthesis of gm-csf and also decreased instances of other site or pies cyclosporine a has many adverse drug reactions one that we’ve commonly seen and other lectures is opportunistic infections which is an infection that a normal healthy person wouldn’t get or is unnormal e severe classically and a really important one that you should remember
Is nephrotoxicity which can lead to hypertension cyclosporine a can also lead to gum patricia and cause skin cancer seizures and neuropathy now we’re going to look at the clinical pharmacology of cyclosporine a little bit cyclosporine has erratic oral bioavailability and therefore we administer it an emulsion formulation it is really important to note that the
Clinician has to monitor the blood concentration levels of cyclosporin 8 when administering yet another really important thing to remember is that if a patient drinks grapefruit juice it will inhibit sip 384 and intestinal epithelium and therefore by inhibiting this enzyme will lead to decreased breakdown ciclosporin 8 and increased levels of cyclosporin a in
The block application amazing use in oregon transportation also in cb s aureus severe atopic dermatitis cycles pouring has also be found effective for some cases of other inflammatory skin disorders such as pure dharma gangrenosum this erotic exuma chronic urticaria beset disease and vt really rubra pilaris welcome to us emily fastrack calm the session we’re
Going to talk about today is wrong first day for the usmle step 1 2013 edition page 209 immunology immunosuppressants what is the mechanism of action of cyclosporine the mechanism of action of cyclosporin is to bind with cyclic villain which is a cytosolic protein this was formed the cyclosporine cycle of filling complex and this complex lost the differentiation
And activation of t-cell but interpreting calcineurin and that counting urine in normal circumstance is what’s responsible for activating the transcription of interleukin 2 2 therefore calcineurin inhibition would prevent the production of interleukin 2 and interest up varies what is the clinical use of cyclosporine the clinical use of cyclosporine is to suppress
Organ rejection after transplantation and it’s also effective in certain autoimmune disorders what are the side effects and toxicities of cyclosporine use that gives form use can lead to nephrotoxicity hypertension hyperlipidemia hyperglycemia tremors gingival hyperplasia and hirsutism define hirsutism hirsutism is just an abnormal group of hair on a person’s face
Or body some more information on this topic click on the link in the description section below for a fake usmle step 1 review be sure to check us out at usmle fat strat comm where we help you review the entire first day for the usmle step 1 with high-quality videos and hundreds of detailed pictures for a better understanding of the material so to learn from the best
Usmle review both be sure to check us out at us emily fast-track com hi i’m dr. amy carlson latter rheumatologist today i’m going to talk about cycles form for the treatment of vasculitis in lewis he can visit our website wwlp.com i print on one of our cycles 180 caplets follow along with this video’s we know that us collided council food on lupus can produce acute
Myocardial infarction so whenever you want to ask about the bus going on lupus yes count cues i’m your car yelling part cyclosporin is also remove is leroy cyclosporine is given by a tablet taking twice a day you’ll need to discuss the dance with your doctor it can take a few months four cycles for indoor work so we need to be patient and there are four things you
Need to do when taking cycles form you should discuss these with your doctor first it’s important to get regular blood tests every tune of four weeks on taking cyclosporine this is to make sure the medication is affecting your blood counts for kidneys second cyclosporin can make it slightly harder hit apply off infections it’s best to stop taking cyclosporine call
Your doctor will give a fever or think you have an infection third sentence form can cause your blood pressure to rise it’s important to have your blood pressure checked on a regular basis and finally there are several prescription medications that are not safe to take the central storm discuss any more medication with your doctor or pharmacist some people can
Feel sick to the stomach bloated have stomach pain organelle diarrhea only take cyclosporine let your doctor know what this becomes a problem cyclosporine can affect your kidneys your kidneys are launched through regular blood and urine testing it’s good to drink 8 to 10 glasses of water a day to flush your kidneys cycle sport could also rarely irritate the liver
Now this is monitored to regulate blood testing thank miss braun can cause a number of other side effects clicking fatigue headache increase hair growth on the phaser arms swelling of the plums flushing painting in the fingers cones tip of the nose tongue or lips weakness and muscle cramps and tremors samples born is not normally taken during pregnancy it become
Pregnant or planning to become pregnant let your doctor know finally when used for long periods of time psycho squad may be associated for the small initiatives government for my skin cancer you can discuss this with your doctor if you’re taking cyclosporine you should call your doctor if you feel sick you want to stop if you’re concerned about any side effects or
If stopped or want to stop their medication for any reason now for cycle sport there are a few other specific reasons to call your doctor if your blood pressure becomes elevated if you think you have a fever or if they got an infection if you’re pregnant or planning to get pregnant if you develop a new severe headache or you’re planning a surgery i hope you found
This video to be useful for more information please your further our website at www infocom the pros it can be used by kill dynamic organization dc drop to cosima chronic ut car bctc p0p lars their motto me shirts pants people cars epidermolysis bullosa at casita leaking plano’s eternity suppurativa porygon allari is systemic sclerosis frozen-columns side effects
Websites where i may include i predation which may require additional medications or control a reduction around fusion which main st reducing the dose cyclosporin or occasional stopping it like like the doctor said from the reader before device leading rebus it i’ve been talking with you treatments from i see various bikini by talking about treatments that do altered
Immune system to try to suppress the abnormal antibody that is made in my sleepy grass that blocks the chemical communication because we leave this that is my cigarettes i will continue talking with you about another medication called cycle score as we discussed earlier cycle storing cellcept came out of the organ transplant experience of the tvs and ladies and
Both of them are used in myasthenia gravis often take it in weeks freeman for they kick in and start working with niacin braids cyclosporine is a medication that was one of the early ones that was actually fda-approved after a an extensive try on that medication so it’s known to be effective nice egress is usually given twice a day the sole legal precinct dosage
And is usually well tolerated however it has one potential serious side effect and that does occasional cause kidney here because of this bring what blood tests have to be done to monitor cycles fine we usually draw a blood level on cyclosporine just before you take your next bills this is calling trough level this allows us to better keep track of the level of
It’s in your blood of cyclosporine on a regular basis hi drop levels are going to be associated we have increased risk of damage try to keep it propped level below a certain them cyclosporine can be used with all the other medications that are used in finest in your ass and remains one of these center line medications that are often if you enable profile using
People that need organs rattle it can also be used here in a ver 4 3 s.u bet’s and rheumatoid arthritis success rates in solid organ transplantation continued your eyes if each measure of success brings with it a new set of challenges signaling the future targeting post inventory pathways the quest to improve long-term outcomes begins with an exploration of the
Initial cascade of events that occurs within the immune system once an opening is transplanted the body mounts in a new response against the allograft t-cells which mediate the immune response require two signals for full activation signal one is mediated through the t-cell receptors engagement with the antigen presented by the mhc on the apc signal to the coast
Inglot ori signal results from receptor ligand interactions that occur between the t cells and the apc this co-stimulation enables t cells to proliferate and mount a sustained response to the allograft all both current and you know suppressive therapies such as calcineurin inhibitors and mtor inhibitors work to prevent t-cell activation and or proliferation their
Targets are not specific to the immune system and may be associated with therapy-related toxicities that may compromise long-term graft and patient outcomes to meet the current challenge of reducing toxicities and prolonging graft and patient survival selective agents are needed while multiple pathways are currently being investigated for the development of lino
Selective agents cd28 is one of the best characterized receptors required for co-stimulation by preventing cd28 from interacting with cd86 on the apc signal to is blocked and the t-cell is rendered a nurturing or avon tonic since cd28 is expressed predominantly on t-cells this pathway offers the potential for amino selectivity possibly reducing the toxicities that
May be associated with less amino selective agents co-stimulation blockade by inhibition of the cd28 pathway is a therapeutic approach with a potential to improve long-term graft and patient
Transcribed from video
Cyclosporine before PCI in patients with AMI By Daniel González
