A 34-Year-Old Kidney Transplant Patient Treated with Cyclosporine Comes to the Office

A 34-year-old kidney transplant patient treated with cyclosporine comes to the office due to nausea and anorexia.  The patient underwent transplantation 6 months ago and had been doing well until recently.  On examination, his blood pressure is 160/96 mm Hg.  There is no tenderness at the site of the transplanted kidney.  Serum creatinine is 3.4 mg/dL, and the serum cyclosporine level is markedly increased.  A month ago, he had normal blood pressure and normal levels of cyclosporine and serum creatinine.  Further questioning reveals that the patient has been drinking increased amounts of grapefruit juice lately as part of an attempt to improve his overall health.  Which of the following mechanisms is most likely responsible for this patient's current condition?

A) Alteration of gastric acidity
B) Inhibition of cytochrome P450 enzymes in the gut wall
C) Modification of transmembrane drug transport
D) Pharmacodynamic potentiation
E) Reduction of plasma protein binding

Correct Answer:

Verified

Unlock this answer now
Get Access to more Verified Answers free of charge

Access For Free