Cyclosporine

1. Ashley Huffman, Nichole Klemz, Alison Peine, Emily Wyman Cyclosporine Immunosuppressant

2. Nursing Student Objectives Identify 2 priority nursing dx for a pt taking Cyclosporine Verbalize 3 side effects of Cyclosporine Briefly verbalize the mechanism of action of Cyclosporine

3. Client Objectives Verbalize the purpose of Cyclosporine therapy Identify 3 adverse reactions to report immediately to the physician

4. What is Cyclosporine? Trade Names Neoral, Sandimmune, Gengraf Uses Prevent transplant rejection, arthritis, psoriasis Dosage/Route PO ~ dose varies onset: unknown, peak: 2-6hr, duration: unknown IV ~ dose varies onset: unknown, peak: end of infusion, duration: unknown

5. Mechanism Inhibits normal immune response by inhibiting interlukin-2, a factor necessary for initiation of T-cell activity Interleukins distinguish self cells from foreign antigens

6. Side Effects CNS- Seizures, tremor CV- Hypertension GI- diarrhea, hepatotoxicity , nausea, vomiting GU- Nephrotoxicity Dermatitis- Hirsutism

7. Patient Education Take medication at the same time each day Avoid grapefruit and grapefruit juices Discuss common side effects with patient

8. Nursing Considerations Prevention of Transplant Rejection Assess for symptoms of organ rejection throughout therapy Psoriasis Assess skin lesions prior to and during therapy Arthritis Assess pain and limitation of movement prior to and during administration

9. Nursing Considerations PO Mix oral solution with milk, chocolate milk, apple juice or orange juice, preferably at room temperature, stir well and drink at once IV Dilute each 1 mL (50 mg) of IV concentrate immediately before use with 20–100 mL of D5W or 0.9% NaCl Infuse slowly over 2–6 hr via infusion pump Check Y-site compatibility

10. Nursing Dx Risk for Infection Chronic Pain Fatigue Impaired skin integrity Impaired tissue integrity