在接受腹腔透析的患者中,阿西克洛维尔和瓦拉西克洛维尔的神经毒性:仍然罕见,但仍然存在
Miguel Moyses Neto1,2, Beatriz Nakagawa1, Suzana Zanardo Chiozi1
1Nephrology, Serviço de Nefrologia de Ribeirao Preto (SENERP), Ribeirao Preto, SP, Brazil.
概括
在接受透析的慢性病患者中,阿西克洛维尔和瓦拉西克洛维尔可以引起神经毒性. 密切监测和剂量调整对于预防这些罕见但严重的不良事件至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 传染性疾病 传染性疾病
- 神经科学是一个神经科学.
背景情况:
- 克洛维尔和克洛维尔是治疗疹病毒感染的标准药物.
- 患有慢性病 (CKD) 的患者,特别是透析患者,由于排泄受损,患药物相关并发症的风险增加.
- 神经毒性是这些抗病毒药物的已知但不常见的并发症.
研究的目的:
- 在自动腹膜透析 (APD) 患者中报告三起神经毒性病例,这些患者接受了治疗疹病毒的阿西克洛维尔或瓦拉西克洛维尔.
- 突出严重功能障碍患者即使在标准剂量中也可能产生神经毒性.
- 强调需要在这个脆弱人群中进行警监测和适当的剂量调整.
主要方法:
- 病例系列报告了三名患有APD的患者,他们在接受治疗黄疹病毒的阿西克洛维尔或瓦拉西克洛维尔后出现了神经症状.
- 临床观察症状发作,特征和药物停用后的解决方案.
- 对功能障碍中阿西克洛维尔/瓦拉西克洛维尔神经毒性的现有文献的综述.
主要成果:
- 三名APD患者出现了一系列的神经症状 (困惑,兴奋,头,幻觉,心动等). 在开始服用阿西克洛维尔或瓦拉西克洛维尔后2-4天.
- 在停止服用抗病毒药物后,症状逐渐消失.
- 疹带病变也与神经症状改善同时回归.
结论:
- 在严重功能障碍患者,包括腹腔透析患者中,阿西克洛维尔和瓦拉西克洛维尔诱导的神经毒性仍然是令人担忧的.
- 即使看似安全的剂量也可以在这个人群中导致神经毒性.
- 严格遵守剂量建议和密切的神经监测对于在透析患者中管理疹病毒感染至关重要.
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