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Ciclosporin, also spelled cyclosporine and cyclosporin, is a calcineurin inhibitor, used as an immunosuppressant medication. It is taken orally or intravenously for rheumatoid arthritis , psoriasis , Crohn's disease , nephrotic syndrome , eczema , and in organ transplants to prevent rejection .
Therapeutic drug monitoring (TDM) is a branch of clinical chemistry and clinical pharmacology that specializes in the measurement of medication levels in blood. Its main focus is on drugs with a narrow therapeutic range , i.e. drugs that can easily be under- or overdosed. [ 1 ]
However, it was then realized that it was possible to individualize a patient's dose of ciclosporin by analysing the patients plasmatic concentrations (pharmacokinetic monitoring). This practice has allowed this drug to be used again and has facilitated a great number of organ transplants.
The usual criterion is concentration in the blood serum, although in some instances local concentration within tissues is relevant. It is pharmacokinetically normal that over time, the drug molecules are being metabolized or cleared by the body, so the concentration of drug that remains available is dropping.
ciclosporin (Cyclosporin A) calcineurin inhibitor: unknown D-penicillamine (seldom used today) Reducing numbers of T-lymphocytes etc. unknown etanercept: decoy TNF receptor: bDMARD filgotinib: Janus kinase (JAK) inhibitor tsDMARD golimumab: TNF inhibitor: bDMARD gold salts (sodium aurothiomalate, auranofin) (seldom used today) unknown csDMARD
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An anesthetic machine with integrated systems for monitoring of several vital parameters, including blood pressure and heart rate. Monitoring of vital parameters can include several of the ones mentioned above, and most commonly include at least blood pressure and heart rate, and preferably also pulse oximetry and respiratory rate.