| Theme | Prescription of Therapeutics and Monitoring for the Dialysis Patients | |
|---|---|---|
| Title | TDM of antiviral drugs commonly used for patients with end stage renal diseases | |
| Publish Date | 1999/11 | |
| Author | Yoshihiko Hoshino | Department of Infectious Diseases and Applied Immunology, Institute of Medical Science, University of Tokyo |
| [ Summary ] | Patients with end-stage renal diseases (ESRD) frequently suffer from viral infections. Anti-herpes viral drugs, anti-influenza viral drugs and anti-hepatitis viral drugs are commonly used to treat these conditions. Vidarabine and aciclovir (ACV) are used to treat patients with either herpes simplex virus or varicella-zoster virus. Both drugs must be used according to the condition of the patient's renal functioning. ACV may be removed by hemodialysis (HD). Overly high dosages of ACV tend to be prescribed to the patients with ESRD. The major side effect of ACV is the occurance of neuro-psychological events. Emergency HD should be performed in these cases. Ganciclovir (GCV) is used to treat patients with cytomegalovirus (CMV) disease. It must also be used in relation to the degree of renal functioning. HD can reduce the concentration of CMV. Amantadine hydrochloride is used to treat patients infected with influenza viruses. It is mainly excreted renally, but can not be removed by HD. Clinicians should carefully give medication to patients with ESRD. Interferon is used in Japan for patients with viral hepatitis. When it is used for patients with ESRD, side effects including heart toxicity may occur. |
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