[Metabolic modifications related to immunosuppressive drugs].
After transplantation, immunosuppressive drugs induce frequently lipid changes and glucose intolerance which result in worsening of the patient's prognosis. The mechanisms of the metabolic changes of corticosteroid hormones, cyclosporine, tacrolimus, sirolimus and mycophelonate are shortly reviewed but are not fully understood. Controlling serum lipids is critical in the management of the patients after transplantation. Statins seem to be the best choice but it remains some concerns about drug interactions and risk of rhabdomyolysis. Fibrates except gemfibrozil are not recommended because potential renal side effects.
Ducobu
J
J
Service de Médecine Interne, C.H.U. Tivoli, La Louvière, U.L.B., C.U.M.G.-U.L.B.
D000924:Anticholesteremic Agents / Q000627:therapeutic use; D016572:Cyclosporine / Q000009:adverse effects; D003920:Diabetes Mellitus / Q000139:chemically induced* / Q000188:drug therapy / Q000378:metabolism; D016027:Heart Transplantation / Q000276:immunology; D006801:Humans; D006949:Hyperlipidemias / Q000139:chemically induced* / Q000188:drug therapy / Q000378:metabolism; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007333:Insulin Resistance; D016031:Liver Transplantation; D016040:Lung Transplantation / Q000276:immunology; D009173:Mycophenolic Acid / Q000009:adverse effects; D011241:Prednisone / Q000009:adverse effects; D011379:Prognosis; D020123:Sirolimus / Q000009:adverse effects; D016559:Tacrolimus / Q000009:adverse effects; D014181:Transplantation Immunology
D000924:Anticholesteremic Agents; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D009173:Mycophenolic Acid; D011241:Prednisone; D020123:Sirolimus; D016559:Tacrolimus