Medication Summary
The goals of pharmacotherapy are to reduce morbidity and to prevent complications.
Immunosuppressive agents
Class Summary
May have a beneficial effect on birdshot chorioretinopathy inflammation.
Cyclosporine (Sandimmune, Neoral)
Cyclic polypeptide that suppresses some humoral immunity and, to a greater extent, cell-mediated immune reactions, such as delayed hypersensitivity, allograft rejection, experimental allergic encephalomyelitis, and graft-versus-host disease for a variety of organs. For children and adults, base dosing on ideal body weight. The dose of 10 mg/kg/d is associated with a high incidence of nephrotoxicity and hypertension.
Corticosteroids
Class Summary
Have both anti-inflammatory (glucocorticoid) and salt-retaining (mineralocorticoid) properties. Glucocorticoids have profound and varied metabolic effects. In addition, these agents modify the body's immune response to diverse stimuli.
Prednisone (Deltasone, Sterapred, Orasone, Meticorten)
Immunosuppressant for treatment of autoimmune disorders; may decrease inflammation by reversing increased capillary permeability and suppressing PMN activity. Stabilizes lysosomal membranes and suppresses lymphocytes and antibody production.
Antifungal agents
Class Summary
Their mechanism of action may involve an alteration of RNA and DNA metabolism or an intracellular accumulation of peroxide that is toxic to the fungal cell. They also may inhibit P450 enzymes involved in drug metabolism.
Ketoconazole (Nizoral)
For use concomitantly with cyclosporine. Imidazole broad-spectrum antifungal agent that acts on several of the P450 enzymes, including the first step in cortisol synthesis, cholesterol side-chain cleavage, and conversion of 11-deoxycortisol to cortisol. Also increases levels of drugs metabolized by P450 enzymes, such as cyclosporine.
