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High on Cannabis and Calcineurin Inhibitors: A Word of Warning in an Era of Legalized Marijuana
Tacrolimus, a potent immunosuppressant medication, acts by inhibiting calcineurin, which eventually leads to inhibition of T-cell activation. The drug is commonly used to prevent graft rejection in solid organ transplant and graft-versus-host disease in hematopoietic stem cell transplant patients. T...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi Publishing Corporation
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4993910/ https://www.ncbi.nlm.nih.gov/pubmed/27595035 http://dx.doi.org/10.1155/2016/4028492 |
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author | Hauser, Naomi Sahai, Tanmay Richards, Rocco Roberts, Todd |
author_facet | Hauser, Naomi Sahai, Tanmay Richards, Rocco Roberts, Todd |
author_sort | Hauser, Naomi |
collection | PubMed |
description | Tacrolimus, a potent immunosuppressant medication, acts by inhibiting calcineurin, which eventually leads to inhibition of T-cell activation. The drug is commonly used to prevent graft rejection in solid organ transplant and graft-versus-host disease in hematopoietic stem cell transplant patients. Tacrolimus has a narrow therapeutic index with variable oral bioavailability and metabolism via cytochrome P-450 3A enzyme. Toxicity can occur from overdosing or from drug-drug interactions with the simultaneous administration of cytochrome P-450 3A inhibitors and possibly P-glycoprotein inhibitors. Tacrolimus toxicity can be severe and may include multiorgan damage. We present a case of suspected tacrolimus toxicity in a postallogeneic hematopoietic stem cell transplant patient who was concurrently using oral marijuana. This case represents an important and growing clinical scenario with the increasing legalization and use of marijuana throughout the United States. |
format | Online Article Text |
id | pubmed-4993910 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Hindawi Publishing Corporation |
record_format | MEDLINE/PubMed |
spelling | pubmed-49939102016-09-04 High on Cannabis and Calcineurin Inhibitors: A Word of Warning in an Era of Legalized Marijuana Hauser, Naomi Sahai, Tanmay Richards, Rocco Roberts, Todd Case Rep Transplant Case Report Tacrolimus, a potent immunosuppressant medication, acts by inhibiting calcineurin, which eventually leads to inhibition of T-cell activation. The drug is commonly used to prevent graft rejection in solid organ transplant and graft-versus-host disease in hematopoietic stem cell transplant patients. Tacrolimus has a narrow therapeutic index with variable oral bioavailability and metabolism via cytochrome P-450 3A enzyme. Toxicity can occur from overdosing or from drug-drug interactions with the simultaneous administration of cytochrome P-450 3A inhibitors and possibly P-glycoprotein inhibitors. Tacrolimus toxicity can be severe and may include multiorgan damage. We present a case of suspected tacrolimus toxicity in a postallogeneic hematopoietic stem cell transplant patient who was concurrently using oral marijuana. This case represents an important and growing clinical scenario with the increasing legalization and use of marijuana throughout the United States. Hindawi Publishing Corporation 2016 2016-08-09 /pmc/articles/PMC4993910/ /pubmed/27595035 http://dx.doi.org/10.1155/2016/4028492 Text en Copyright © 2016 Naomi Hauser et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Hauser, Naomi Sahai, Tanmay Richards, Rocco Roberts, Todd High on Cannabis and Calcineurin Inhibitors: A Word of Warning in an Era of Legalized Marijuana |
title | High on Cannabis and Calcineurin Inhibitors: A Word of Warning in an Era of Legalized Marijuana |
title_full | High on Cannabis and Calcineurin Inhibitors: A Word of Warning in an Era of Legalized Marijuana |
title_fullStr | High on Cannabis and Calcineurin Inhibitors: A Word of Warning in an Era of Legalized Marijuana |
title_full_unstemmed | High on Cannabis and Calcineurin Inhibitors: A Word of Warning in an Era of Legalized Marijuana |
title_short | High on Cannabis and Calcineurin Inhibitors: A Word of Warning in an Era of Legalized Marijuana |
title_sort | high on cannabis and calcineurin inhibitors: a word of warning in an era of legalized marijuana |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4993910/ https://www.ncbi.nlm.nih.gov/pubmed/27595035 http://dx.doi.org/10.1155/2016/4028492 |
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