Probenecid adverse effects

Its main adverse effect is hepatotoxicity which is dose dependent but still occurs in some 5% of the patients. Hyperuricemia is seen in almost all patients. When gout becomes manifest it does not respond to treatment with probenecid. 

Adverse effects do not provide a basis for preferring one or the other of the uricosuric agents. Both of these organic acids cause gastrointestinal irritation, but sulfinpyrazone is more active in this regard. A rash may appear after the use of either compound. Nephrotic syndrome has occurred after the use of probenecid. Both sulfinpyrazone and probenecid may rarely cause aplastic anemia. 

Cephalexin (Keflex, Panixine DisperDose) [Antibiotic/ Cephalosporin-1st Generation] Uses Skin, bone, upper/lower resp tract, urinary tract Infxns Action lst-gen cephalosporin X- cell wall synth Dose Adults. 250-1000 mg PO qid Feds. 25—100 mg/kg/d PO - qid 4- in renal impair (on empty stomach) Caution [B, +] Contra Cephalosporin allergy Disp Caps, tabs, susp SE D, rash, eosinophilia, T LFTs Interactions T Nephrotox W/aminoglycosides, loop diuretics T effects W/probenecid EMS T Risk of adverse effects w/ loop diuretics monitor for signs of electrolyte disturbances and hypovolemia d/t D monitor pt for super Infxn OD May cause N/V/D, Szs, muscles spasms symptomatic and supportive... 

The primary adverse effect of intravenous cidofovir is a dose-dependent nephrotoxicity. Concurrent administration of other potentially nephrotoxic agents (eg, amphotericin B, aminoglycosides, nonsteroidal anti-inflammatory drugs, pentamidine, foscarnet) should be avoided. Prior administration of foscarnet may increase the risk of nephrotoxicity. Other potential side effects include uveitis, decreased intraocular pressure, and probenecid-related hypersensitivity reactions. Neutropenia and metabolic acidosis are rare. The drug caused mammary adenocarcinomas in rats and is embryotoxic. 

Ind avenous cidofovir is well tolerated. The major deatment-limidng toxicity of this drug is irreversible nephrotoxicity (Plosker and Noble, 1999). Ind avenous pre-hydradon with normal saline and aclminisdadon of oral probenecid must be used with each cidofovir infusion to lessen the effects on the kidney. Serum creadnine and urine protein must be monitored with each infusion and adjusted accordingly. Other adverse effects associated with its use are neudopenia and peripheral neuropathy (Plosker and Noble, 1999). 

Probenecid and sulfinpyrazone decrease the uric acid pool by inhibiting the proximal resorption of s urate. Their use and adverse effects are discussed. 

Zidovudine is rapidly absorbed from the G1 tract with peak serum concentrations occurring within 30 to 90 minutes. It binds to plasma proteins to the extent of 35 to 40%. Zidovudine is rapidly metabolized in the liver to the inactive 3 -azido-3 -deoxy-5 -0-beta-D-glucopyranuronosylthymi-dine (GAZT), which has an apparent elimination half-life of 1 hour. Zidovudine undergoes glomerular filtration and active tubular secretion. Coadministration of zidovudine with agents such as dapsone, pentamidine, amphotericin B, flucytosine, vincristine, vinblastine, adriamycin, and interferon with potential to cause nephrotoxicity or cytotoxicity to hematopoietic elements, enhance its risk of adverse effects. Probenecid will inhibit the renal excretion of zidovudine. 

Famciclovir can be given with or without food. The most common adverse effects are headache and Gl disturbances. Concomitant use of famciclovir with probenecid results in increased plasma concentratiens of penciclovir. The recommended dose of famciclovir is 500 mg every 8 hours for 7 days. The absolute bioavailability of famciclovir is 77%, and the area under plasma concentration-time curve (AUC) is 86 pg/mL. Famcicicvir with digexin increased plasma ccncentraticn cf digexin tc 19% as compared to digoxin given alone. 

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