Foscarnet: Difference between revisions

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*Active against all [[human herpesviruses]]
 
*Active against all [[human herpesviruses]]
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=== Mechanism of Action ===
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* Acts as a pyrophosphate analogue that competitively and reversibly inhibits herpesvirus DNA polymerase, causing premature chain termination of DNA
   
 
===Pharmacokinetics and Pharmacodynamics===
 
===Pharmacokinetics and Pharmacodynamics===
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==Safety==
 
==Safety==
   
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=== Adverse Events ===
*Nephrotoxicity, usually reversible
 
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*Electrolyte abnormalities, including [[hypocalcemia]], [[hypophosphatemia]], [[hyperphosphatemia]], [[hypomagnesemia]], and [[hypokalemia]]
 
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*Most common AEs include infusion-related [[nausea]], electrolyte abnormalities, and [[acute kidney injury]]
*Seizures
 
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**Renal tubular nephrotoxicity is common, dose-dependent, and usually reversible if drug is stopped early
*Genital ulcers
 
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**Crystal glomerular nephropathy also occurs
*Anemia
 
 
**Electrolyte abnormalities, including [[hypocalcemia]], [[hypophosphatemia]], [[hyperphosphatemia]], [[hypomagnesemia]], and [[hypokalemia]]
*Nausea
 
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**Nausea is very common, and can be debilitating
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***Minimize with concurrent IV and oral hydration, antiemetics, and slowing the infusion rate[[CiteRef::jayaweera1997mi]]
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*Other AEs include:
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**[[Seizure]]
 
**[[Genital ulcers]]
 
**[[Anemia]]
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**[[Nephrogenic diabetes insipidus]]
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=== Monitoring ===
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* Close monitoring of electrolytes and creatinine is required
   
 
[[Category:Antivirals]]
 
[[Category:Antivirals]]

Revision as of 10:36, 5 December 2020

Background

Spectrum of Activity

Mechanism of Action

  • Acts as a pyrophosphate analogue that competitively and reversibly inhibits herpesvirus DNA polymerase, causing premature chain termination of DNA

Pharmacokinetics and Pharmacodynamics

  • CSF penetration 66% of serum levels

Dosing

Pediatric Dosing

  • Induction: foscarnet 60 mg/kg IV q8h or 90 mg/kg IV q12h
  • Maintenance: foscarnet 90 to 120 mg/kg IV q24h

Safety

Adverse Events

Monitoring

  • Close monitoring of electrolytes and creatinine is required

References

  1. ^  Dushyantha T. Jayaweera. Minimising the Dosage-Limiting Toxicities of Foscarnet Induction Therapy. Drug Safety. 1997;16(4):258-266. doi:10.2165/00002018-199716040-00003.