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Nursing considerations for corticosteroids and immunosuppressants
Nursing considerations for corticosteroids and immunosuppressants ( 3 Questions)
A nurse is caring for a client who has a kidney transplant and is receiving cyclosporine (Sandimmune), a calcineurin inhibitor. What is the primary mechanism of action of cyclosporine in this condition?
Option A is incorrect because cyclosporine does not inhibit the synthesis of inflammatory mediators or suppress the activation and proliferation of immune cells in general. Cyclosporine is a selective inhibitor of calcineurin, which is mainly involved in T cell activation. Cyclosporine does not affect other inflammatory mediators such as prostaglandins, leukotrienes, or histamine, or other immune cells such as B cells, macrophages, or natural killer cells¹².
Cyclosporine blocks the activation of T cells by inhibiting the enzyme calcineurin, which is required for the transcription of interleukin-2¹². Interleukin-2 is a cytokine that stimulates the proliferation and differentiation of T cells, which are responsible for recognizing and attacking foreign antigens on the donor organ. By blocking interleukin-2 production, cyclosporine prevents the activation and expansion of T cells, and thus reduces the immune response to the transplanted organ¹³.
Option C is incorrect because cyclosporine does not interfere with the synthesis of nucleic acids, which are essential for the replication and function of immune cells. Cyclosporine does not directly affect DNA or RNA synthesis or function, but rather modulates gene expression through its interaction with cyclophilin and calcineurin. Cyclosporine may have some anti-cancer effects by inducing apoptosis or inhibiting angiogenesis in some malignant cells, but this is not its primary mechanism of action¹².
Option D is incorrect because cyclosporine does not bind to specific antigens or receptors on the surface of immune cells and either neutralize them or induce their destruction. Cyclosporine acts intracellularly by binding to cyclophilin and inhibiting calcineurin, which are both involved in signal transduction pathways that regulate T cell activation. Cyclosporine does not directly bind to or affect the antigen recognition or receptor-mediated signaling of immune cells¹².
Cyclosporine blocks the activation of T cells by inhibiting the enzyme calcineurin, which is required for the transcription of interleukin-2¹². Interleukin-2 is a cytokine that stimulates the proliferation and differentiation of T cells, which are responsible for recognizing and attacking foreign antigens on the donor organ. By blocking interleukin-2 production, cyclosporine prevents the activation and expansion of T cells, and thus reduces the immune response to the transplanted organ¹³.
The other options are incorrect because:
- Option A is incorrect because cyclosporine does not inhibit the synthesis of inflammatory mediators or suppress the activation and proliferation of immune cells in general. Cyclosporine is a selective inhibitor of calcineurin, which is mainly involved in T cell activation. Cyclosporine does not affect other inflammatory mediators such as prostaglandins, leukotrienes, or histamine, or other immune cells such as B cells, macrophages, or natural killer cells¹².
C. Option C is incorrect because cyclosporine does not interfere with the synthesis of nucleic acids, which are essential for the replication and function of immune cells. Cyclosporine does not directly affect DNA or RNA synthesis or function, but rather modulates gene expression through its interaction with cyclophilin and calcineurin. Cyclosporine may have some anti-cancer effects by inducing apoptosis or inhibiting angiogenesis in some malignant cells, but this is not its primary mechanism of action¹².
D. Option D is incorrect because cyclosporine does not bind to specific antigens or receptors on the surface of immune cells and either neutralize them or induce their destruction. Cyclosporine acts intracellularly by binding to cyclophilin and inhibiting calcineurin, which are both involved in signal transduction pathways that regulate T cell activation. Cyclosporine does not directly bind to or affect the antigen recognition or receptor-mediated signaling of immune cells¹².