Foscarnet: Difference between revisions
From IDWiki
No edit summary |
No edit summary |
||
| Line 8: | Line 8: | ||
*Active against all [[human herpesviruses]] |
*Active against all [[human herpesviruses]] |
||
| − | === |
+ | ===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=== |
===Pharmacokinetics and Pharmacodynamics=== |
||
| Line 25: | Line 25: | ||
==Safety== |
==Safety== |
||
| − | === |
+ | ===Adverse Events=== |
*Most common AEs include infusion-related [[nausea]], electrolyte abnormalities, and [[acute kidney injury]] |
*Most common AEs include infusion-related [[nausea]], electrolyte abnormalities, and [[acute kidney injury]] |
||
| Line 34: | Line 34: | ||
***Minimize with concurrent IV and oral hydration, antiemetics, and slowing the infusion rate[[CiteRef::jayaweera1997mi]] |
***Minimize with concurrent IV and oral hydration, antiemetics, and slowing the infusion rate[[CiteRef::jayaweera1997mi]] |
||
*Other AEs include: |
*Other AEs include: |
||
| − | **[[Seizure]] |
+ | **[[Seizure]], usually in patients with concurrent CNS pathology |
| − | **[[Genital ulcers]] |
+ | **[[Genital ulcers]], which slowly heal once the drug is stopped |
**[[Anemia]] |
**[[Anemia]] |
||
**[[Nephrogenic diabetes insipidus]] |
**[[Nephrogenic diabetes insipidus]] |
||
| − | === |
+ | ===Monitoring=== |
| − | * |
+ | *Close monitoring of electrolytes and creatinine is required |
[[Category:Antivirals]] |
[[Category:Antivirals]] |
||
Revision as of 10:38, 5 December 2020
Background
- Inhibits DNA polymerase in human herpesviruses
- Indications: CMV after hematopoietic stem cell transplantation, CMV after solid organ transplantation, Cytomegalovirus, Herpes simplex virus, Herpesviridae, Post-transplant acute limbic encephalitis
Spectrum of Activity
- Active against all human herpesviruses
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
- Most common AEs include infusion-related nausea, electrolyte abnormalities, and acute kidney injury
- Renal tubular nephrotoxicity is common, dose-dependent, and usually reversible if drug is stopped early
- Crystal glomerular nephropathy also occurs
- Electrolyte abnormalities, including hypocalcemia, hypophosphatemia, hyperphosphatemia, hypomagnesemia, and hypokalemia
- Nausea is very common, and can be debilitating
- Minimize with concurrent IV and oral hydration, antiemetics, and slowing the infusion rate1
- Other AEs include:
- Seizure, usually in patients with concurrent CNS pathology
- Genital ulcers, which slowly heal once the drug is stopped
- Anemia
- Nephrogenic diabetes insipidus
Monitoring
- Close monitoring of electrolytes and creatinine is required
References
- ^ 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.
