Question
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- (a) Discuss the adverse effects of Oral contraceptives. ( 4 mark(s)
- (b) Describe the mechanism of action, adverse effects and Uses of Cyclosporine. 4 mark(s)
Answer
a) Adverse effects of oral contraceptives Thromboembolism (estrogen-driven, increased risk in smokers over 35 years), breakthrough bleeding, headache, weight gain, nausea, mood changes, and — rarely — hepatic adenoma with long-term use. Estrogen-related cardiovascular risk is the most clinically significant concern.
b) Cyclosporine — mechanism, adverse effects, uses Mechanism: binds the intracellular immunophilin cyclophilin; the resulting complex inhibits calcineurin’s phosphatase activity, preventing dephosphorylation/nuclear translocation of NFAT, blocking IL-2 gene transcription at its source and thereby T-cell activation/proliferation.
Uses: prevention of organ transplant rejection, severe autoimmune disease refractory to other therapy (rheumatoid arthritis, psoriasis).
Adverse effects: nephrotoxicity (dose-limiting — direct renal vasoconstriction and, with chronic use, interstitial fibrosis; can be difficult to distinguish clinically from graft rejection in a transplant recipient, requiring biopsy), hypertension, gingival hyperplasia and hirsutism, increased infection/malignancy risk from immunosuppression.