Q: Which drug is more prone to cause acute kidney dysfunction? (select one)
A) IV Acyclovir
B) IV Ganciclovir
Answer: A
Acyclovir has low solubility and gets rapidly excreted in the urine. In a hypovolemic patient, deposition of acyclovir crystals in the tubules occurs quickly, causing an intratubular obstruction and interstitial inflammation. Ganciclovir does the same thing but with lesser intensity. Patients may complain of kidney stones like symptoms. The best prevention is IV hydration, adequate urine output @ 75 mL/hour and slow infusion of the drug.
#nephrology
#pharmacology
References:
Sawyer MH, Webb DE, Balow JE, Straus SE. Acyclovir-induced renal failure. Clinical course and histology. Am J Med 1988; 84:1067.
A) IV Acyclovir
B) IV Ganciclovir
Answer: A
Acyclovir has low solubility and gets rapidly excreted in the urine. In a hypovolemic patient, deposition of acyclovir crystals in the tubules occurs quickly, causing an intratubular obstruction and interstitial inflammation. Ganciclovir does the same thing but with lesser intensity. Patients may complain of kidney stones like symptoms. The best prevention is IV hydration, adequate urine output @ 75 mL/hour and slow infusion of the drug.
#nephrology
#pharmacology
References:
Sawyer MH, Webb DE, Balow JE, Straus SE. Acyclovir-induced renal failure. Clinical course and histology. Am J Med 1988; 84:1067.
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