末期脏病患者的瓦拉基克洛维尔神经毒性:审查了两个病例
Bernadette Gublo1, Amy Beth St Amand1, Anupama Menon1
1Clinical Pharmacy, Providence Veteran Affairs Medical Center, Providence, RI, USA.
Journal of pharmacy practice
|January 22, 2024
概括
如果药物剂量没有调整,环神经毒性 (VAN) 可能发生在末期脏疾病 (ESRD) 的患者中. 适当的剂量和血液透析对于预防和治疗严重的VAN并发症至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 药理学 药理学是指药理学的学科.
- 神经科学是一个神经科学.
背景情况:
- 瓦拉西克洛维尔是阿西克洛维尔的前期药物,通常用于治疗疹感染.
- 脏清除是瓦拉西克洛维尔及其代谢物的主要排泄途径.
- 功能受损,特别是末期病 (ESRD),可能导致药物积累和毒性.
研究的目的:
- 突出不同临床表现的瓦拉环维尔相关的神经毒性 (VAN).
- 强调在末期脏病 (ESRD) 患者接受血液透析时适当调整药物治疗的关键需要.
- 预防脆弱患者群体中与瓦拉环科维尔相关的并发症.
主要方法:
- 一系列病例详细介绍了两名老年患者的临床结果.
- 患者接受了与功能相关的六倍推剂量的瓦拉环.
- 评估需要住院治疗的神经和身体表现,以及新出现的血液透析.
主要成果:
- 由于未能调整瓦赛克洛维尔剂量,导致严重的神经毒性和身体症状.
- 由于副作用,需要住院和紧急血液透析.
- 该案例系列强调了不适当的剂量和VAN严重程度之间的直接联系.
结论:
- 根据功能调整瓦拉环的剂量至关重要.
- 在ESRD患者中,瓦拉西克洛维尔的半衰期可延长至14小时.
- 血液透析是严重VAN的有效干预措施,促进药物的快速分泌和恢复.
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