History, pharmacokinetics, and pharmacology of acyclovir

King, Dannie H.

doi:10.1016/s0190-9622(88)70022-5

Cited by 65 publications

(34 citation statements)

References 13 publications

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“…Most current cases of HSE are left with relatively circumscribed unilateral lesions (e.g., Tranel et al, 2000). Much of this reduced brain damage can be attributed to the introduction of acyclovir, a potent antiviral medication (King, 1988). Unfortunately for Roger, acyclovir's efficacy was not discovered until the mid-1980's, a few years after the onset of his encephalitic attack (Kennedy, 1988; Skoldenberg et al, 1984; Whitley et al, 1986).…”

Section: Discussionmentioning

confidence: 99%

Bilateral limbic system destruction in man

Feinstein

Rudrauf

Khalsa

et al. 2010

Journal of Clinical and Experimental Neuropsychology

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We report here a case study of a rare neurological patient with bilateral brain damage encompassing a substantial portion of the so-called "limbic system." The patient, Roger, has been studied in our laboratory for over 14 years and the current article presents his complete neuroanatomical and neuropsychological profiles. The brain damage occurred in 1980 following an episode of herpes simplex encephalitis. The amount of destroyed neural tissue is extensive and includes bilateral damage to core limbic and paralimbic regions, including the hippocampus, amygdala, parahippocampal gyrus, temporal poles, orbitofrontal cortex, basal forebrain, anterior cingulate cortex, and insular cortex. The right hemisphere is more extensively affected than the left, although the lesions are largely bilateral. Despite the magnitude of his brain damage, Roger has a normal IQ, average to above average attention, working memory, and executive functioning skills, and very good speech and language abilities. In fact, his only obvious presenting deficits are a dense global amnesia and a severe anosmia and ageusia. Roger's case presents a rare opportunity to advance our understanding of the critical functions underlying the human limbic system, and the neuropsychological and neuroanatomical data presented here provide a critical foundation for such investigations.

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Section: Discussionmentioning

confidence: 99%

Bilateral limbic system destruction in man

Feinstein

Rudrauf

Khalsa

et al. 2010

Journal of Clinical and Experimental Neuropsychology

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“…Treatment of herpesvirus infections primarily relies on nucleoside analog inhibitors of the viral DNA polymerase, including acyclovir (ACV), penciclovir, ganciclovir, valaciclovir, valganciclovir, brivudine, and famciclovir (10,11). Several newer agents are undergoing clinical development (11,12), but none of them can fully suppress herpesvirus infections (12).…”

mentioning

confidence: 99%

Inhibitors of Nucleotidyltransferase Superfamily Enzymes Suppress Herpes Simplex Virus Replication

Tavis

Wang

Tollefson

et al. 2014

Antimicrob Agents Chemother

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“…Acyclovir has been the standard in treating herpes simplex virus (HSV) 1 and 2 infections since 1982 . This drug is a nucleoside analogue, activated following conversion to acyclovir monophosphate and ultimately acyclovir triphosphate, via virus‐specific thymidine kinase and various cellular enzymes, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…The final product prevents DNA replication by binding to viral DNA polymerase—terminating viral DNA production, effectively abating flares . Acyclovir pharmacodynamics display 15%–30% oral absorption, primary excretion through the urine (62%–90%), a volume of distribution of 0.8 L/kg in adults, and a half‐life of 20 hours in ESRD patients, as compared to 3–5 hours in adults with normal renal function . This medication is water‐soluble and has a low‐protein binding capacity of 15% .…”

Section: Discussionmentioning

confidence: 99%

Sticking to the script: A curious case of confusion in an ESRD patient

Gorlitsky

Herion

2017

Hemodialysis International

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A 60-year-old male Dialysis patient presented with altered mental status and Hypertensive Urgency. He had a significant lesion noted on his glans penis. He was treated for infection and hypertension with expectant management, without significant improvement in his mental acuity. Laboratory and radiologic workup were unrevealing for the etiology. Upon detailed review it was noted he had recently been given Acyclovir for a presumed Herpes Simplex Virus infection. He had been prescribed what is considered correct dosing for an ESRD patient. An Acyclovir level was obtained and urgent Dialysis was undertaken, presuming Acyclovir neurotoxicity may be the culprit. Initially no improvement was noted and a 2nd level and hemodialysis were undertaken. This case and review of the literature will highlight key aspects of acyclovir neurotoxicity in ESRD patients, including how to diagnose and treat, which laboratory tests to obtain and what one can expect from various dialysis modalities. We will also reveal how to dose Acyclovir to avoid toxicity and other key elements of the drug.

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History, pharmacokinetics, and pharmacology of acyclovir

Cited by 65 publications

References 13 publications

Bilateral limbic system destruction in man

Bilateral limbic system destruction in man

Inhibitors of Nucleotidyltransferase Superfamily Enzymes Suppress Herpes Simplex Virus Replication

Sticking to the script: A curious case of confusion in an ESRD patient

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