Unexpected overdose of oral cyclosporine in a kidney transplant patient: a case report.

Autor:	Bacle A; Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU Rennes, Rennes, France astrid.bacle@univ-rennes1.fr.; Univ Rennes, CHU Rennes, Inserm, EHESP, IRSET (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France., Lhermitte R; Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU Rennes, Rennes, France., Le Daré B; Laboratoire de toxicologie et médico-légale, CHU Rennes, Rennes, France.; NSERM, INRAE, Institut NuMeCan (Nutrition, Metabolisms and Cancer), Réseau PREVITOX, Rennes 1 University, Rennes, France., Mercerolle M; Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU Rennes, Rennes, France., Vigneau C; Univ Rennes, CHU Rennes, Inserm, EHESP, IRSET (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France., Le Corre P; Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU Rennes, Rennes, France.; Univ Rennes, CHU Rennes, Inserm, EHESP, IRSET (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France., Chemouny JM; Univ Rennes, CHU Rennes, Inserm, EHESP, IRSET (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France.
Jazyk:	angličtina
Zdroj:	European journal of hospital pharmacy : science and practice [Eur J Hosp Pharm] 2023 Jul; Vol. 30 (4), pp. 242-244. Date of Electronic Publication: 2021 Jun 11.
DOI:	10.1136/ejhpharm-2021-002730
Abstrakt:	Cyclosporine is a widely used immunosuppressive agent to prevent rejection of solid organ transplant. Here, we describe the case of a 71-year-old man who received the prescribed dose of cyclosporine 10 times 6 days after a kidney transplantation because of a concentration miscalculation involving two galenic forms. The patient presented gastrointestinal and neurological disorders. Therapeutic drug monitoring revealed high cyclosporine blood concentrations (693 ng/mL, therapeutic range 100-300 ng/mL). Symptomatic management of digestive disorders was performed, and haemodialysis was started the day after the cyclosporine overdose in the face of acute renal failure. The patient's disorders were quickly resolved. The dosing regimen was adapted in order to administer the most appropriate galenic form and to avoid another administration error. Long-term follow-up showed no failure of renal transplantation. The purpose of this case report is to warn physicians and clinical pharmacists about the vigilance required on cyclosporine prescription, especially when two galenic forms are administered to obtain the prescribed dose. Competing Interests: Competing interests: None declared. (© European Association of Hospital Pharmacists 2023. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu