Side effects of cyclosporine are all, EXCEPT :
**Question:** Side effects of cyclosporine are all, EXCEPT:
A. Hypertension
B. Hyperglycemia
C. Renal artery spasm
D. Gastric ulceration
**Core Concept:** Cyclosporine is an immunosuppressive drug used after organ transplantation to prevent rejection and in certain autoimmune disorders. It works by inhibiting the enzyme calcineurin, leading to reduced production of cytokines and suppression of the immune system. The drug can cause various side effects due to its actions on the cardiovascular, endocrine, and gastrointestinal systems.
**Why the Correct Answer is Right:** Cyclosporine can cause hypertension (A) due to its ability to increase renin-angiotensin-aldosterone system (RAAS) activity and vasoconstriction. Hyperglycemia (B) is a side effect resulting from its immunosuppressive properties, which impair pancreatic beta cell function. Renal artery spasm (C) can be attributed to cyclosporine's vasoconstrictive properties, affecting the renal circulation and potentially leading to renal artery spasm. Gastric ulceration (D) is a consequence of its direct cytotoxic effect on gastric mucosal cells, weakening the gastrointestinal mucosal barrier and predisposing to ulcer formation.
**Why Each Wrong Option is Incorrect:**
Option A (hypertension) is incorrect because cyclosporine increases RAAS activity, leading to vasoconstriction and hypertension.
Option B (hyperglycemia) is incorrect because cyclosporine directly affects pancreatic beta cells, impairing their function and causing hyperglycemia.
Option C (renal artery spasm) is incorrect because cyclosporine's vasoconstrictive properties affect the renal circulation, potentially causing renal artery spasm.
Option D (gastric ulceration) is incorrect because cyclosporine directly damages gastric mucosal cells, weakening the gastrointestinal mucosal barrier and increasing gastric ulcer risk.
**Clinical Pearl:** Understanding the mechanisms underlying cyclosporine-induced side effects is crucial for proper drug monitoring and management in transplant patients and those receiving cyclosporine for autoimmune disorders.
In summary, the correct answer is D (gastric ulceration), as it arises from the direct cytotoxic effect of cyclosporine on gastric mucosal cells, causing mucosal damage and impaired healing. Monitoring for this side effect is essential to adjust the drug dosage and prevent complications.