Cyclophosphamide and Cyclosporin

[thefritz]

I have a very hard time with these 2 drugs.
What are the keys for each to know for USMLE step 2?
Anyone have good ways to keep from getting them mixed up?

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[drk]

No idea on cyclosporin and don't even feel that it is as high yield as cyclophosphamide.

I remember cyclophosphamide for it's use in Wegener's - Pathoma taught me to remember it as WeCeners - C showing upper respiratory, lower respiratory, and kidney involvement if you drew a C on a stick figure, C being for C-ANCA +, and C being treated by Cyclophosphamide.

The only other important fact is that it causes hemorrhagic cystitis which can be treated/avoided by giving it concurrently with MESNA. The toxic metabolite produced is known as acrolein I believe.

 

[StrangerX]

Krazy Klanging Kould Help: When you be Sporrr (t)in some new bling (aka organs) you better be 'rollin in some cyclosporrrrin.

It is key for tissue transplant.

 

[thefritz]

They confuse me because they are both used for autoimmune conditions, especially RA.

I can see where "patient develops hemorrhagic cystitis, what caused this" is a testable concept for cyclophosphamide.

What are testable concepts for cyclosporin? Renal toxicity? Hirsutism?

I don't see how they could ask anything other than adverse effects on these since they can be used in so many disorders.

Are they first-line for ANYTHING?

 

[CDI]

You didn't listen to Goljan?

Wegeners -> C-ANCA -> cyclophosphamide -> hemorrhagic cystitis -> MESNA

Know that, and only that.

 

[futuredoctor10]

Cyclosporine: immunosuppressant used in organ transplantation to prevent rejection, can be used as prophylaxis against GVHD in bone marrow transplant patients. Adverse effect of gingival hyperplasia.

Cyclophosphamide: can be used for Wegener's and as a chemotherapy agent, Adverse Effect of hemorrhagic cystitis as mentioned above

 

[JRjcu08]

Cyclosporine also is available in topical form (Restasis) for chronic dry eye (think Sjögren syndrome).I feel like I've seen that q before somewhere...

 

[thefritz]

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[thefritz]

There is a test bank question that basically asks which immunosuppresant causes hypertrophy of oral mucosa and cyclosporin is the answer, which is stated as an 'extremely high yield for usmle' fact.

So I don't think it's enough to only know the buzzwords for cyclophosphamide. Simply knowing that cyclosporin causes renal failure also wasn't enough here. Tacrolimus causes renal failure also.

I feel like we need to know the unique adverse effects of every single suppressant. Want to get a list going?