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

IF 1.5 Q3 PHARMACOLOGY & PHARMACY
Bernadette Gublo, Amy Beth St Amand, Anupama Menon, Alissa A Scalise
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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。
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来源期刊
CiteScore
2.90
自引率
5.60%
发文量
146
期刊介绍: The International Journal of Pharmacy Practice (IJPP) is a Medline-indexed, peer reviewed, international journal. It is one of the leading journals publishing health services research in the context of pharmacy, pharmaceutical care, medicines and medicines management. Regular sections in the journal include, editorials, literature reviews, original research, personal opinion and short communications. Topics covered include: medicines utilisation, medicine management, medicines distribution, supply and administration, pharmaceutical services, professional and patient/lay perspectives, public health (including, e.g. health promotion, needs assessment, health protection) evidence based practice, pharmacy education. Methods include both evaluative and exploratory work including, randomised controlled trials, surveys, epidemiological approaches, case studies, observational studies, and qualitative methods such as interviews and focus groups. Application of methods drawn from other disciplines e.g. psychology, health economics, morbidity are especially welcome as are developments of new methodologies.
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