Valacyclovir Neurotoxicity in Patients with End-Stage Renal Disease: Two Cases Reviewed.

IF 0.5 Q4 ENGINEERING, ENVIRONMENTAL
Bernadette Gublo, Amy Beth St Amand, Anupama Menon, Alissa A Scalise
{"title":"Valacyclovir Neurotoxicity in Patients with End-Stage Renal Disease: Two Cases Reviewed.","authors":"Bernadette Gublo, Amy Beth St Amand, Anupama Menon, Alissa A Scalise","doi":"10.1177/08971900221127061","DOIUrl":null,"url":null,"abstract":"<p><p><b>Purpose:</b> The objective of this case series is to highlight different manifestations of valacyclovir associated neurotoxicity (VAN) and demonstrate the importance of adjusting medication appropriately in patients with end-stage renal disease (ESRD) on hemodialysis to prevent these complications. <b>Summary:</b> Valacyclovir is a medication used to treat herpes zoster infection, commonly known as shingles. Valacyclovir is renally cleared and can accumulate in patients with renal dysfunction leading to severe side effects due to the prolonged half-life. VAN is a common adverse effect in patients with underlying kidney disease, that can be easily prevented if valacyclovir is properly dosed. This case series details the clinical outcomes of two elderly patients who were prescribed valacyclovir at six-times the recommended dose based on their renal function. Failure to reduce the dose of valacyclovir resulted in severe neurological and physical manifestations that required hospital admission and emergent hemodialysis. <b>Conclusion:</b> This case series details the importance of adjusting valacyclovir dose based on renal function. In patients with ESRD, the half-life of valacyclovir can be up to 14 hours, therefore hemodialysis should be utilized in severe cases of neurotoxicity to improve rapid excretion of the drug and promote rapid recovery from VAN.</p>","PeriodicalId":13984,"journal":{"name":"International Journal of Environmental Technology and Management","volume":"13 1","pages":"248-251"},"PeriodicalIF":0.5000,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Environmental Technology and Management","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/08971900221127061","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/9/13 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"ENGINEERING, ENVIRONMENTAL","Score":null,"Total":0}
引用次数: 0

Abstract

Purpose: The objective of this case series is to highlight different manifestations of valacyclovir associated neurotoxicity (VAN) and demonstrate the importance of adjusting medication appropriately in patients with end-stage renal disease (ESRD) on hemodialysis to prevent these complications. Summary: Valacyclovir is a medication used to treat herpes zoster infection, commonly known as shingles. Valacyclovir is renally cleared and can accumulate in patients with renal dysfunction leading to severe side effects due to the prolonged half-life. VAN is a common adverse effect in patients with underlying kidney disease, that can be easily prevented if valacyclovir is properly dosed. This case series details the clinical outcomes of two elderly patients who were prescribed valacyclovir at six-times the recommended dose based on their renal function. Failure to reduce the dose of valacyclovir resulted in severe neurological and physical manifestations that required hospital admission and emergent hemodialysis. Conclusion: This case series details the importance of adjusting valacyclovir dose based on renal function. In patients with ESRD, the half-life of valacyclovir can be up to 14 hours, therefore hemodialysis should be utilized in severe cases of neurotoxicity to improve rapid excretion of the drug and promote rapid recovery from VAN.

终末期肾病患者的伐昔洛韦神经毒性:两例病例回顾。
目的:本病例系列旨在强调伐昔洛韦相关神经毒性(VAN)的不同表现,并说明对接受血液透析的终末期肾病(ESRD)患者适当调整药物以预防这些并发症的重要性。摘要:伐昔洛韦是一种用于治疗带状疱疹感染(俗称带状疱疹)的药物。伐昔洛韦经肾脏清除,由于半衰期延长,可在肾功能不全患者体内蓄积,导致严重的副作用。VAN是患有基础肾病的患者常见的不良反应,如果伐昔洛韦剂量适当,这种不良反应很容易预防。本系列病例详细描述了两名老年患者的临床结果,根据他们的肾功能,医生给他们开出了六倍于推荐剂量的伐昔洛韦。如果不减少伐昔洛韦的剂量,就会导致严重的神经和躯体症状,需要入院治疗并进行紧急血液透析。结论本系列病例详细说明了根据肾功能调整伐昔洛韦剂量的重要性。对于 ESRD 患者,伐昔洛韦的半衰期可长达 14 小时,因此在神经毒性严重的病例中应使用血液透析来改善药物的快速排泄,促进 VAN 的快速康复。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
1.00
自引率
0.00%
发文量
66
期刊介绍: IJETM is a refereed and authoritative source of information in the field of environmental technology and management. Together with its sister publications IJEP and IJGEnvI, it provides a comprehensive coverage of environmental issues. It deals with the shorter-term, covering both engineering/technical and management solutions.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信