Shay L E, Wyvill K M
National Cancer Institute, Bethesda, Md.
Nurse Pract. 1992 Dec;17(12):59-64.
There have been reports in the medical community of hesitation regarding the administration of didanosine to adult HIV patients because of the fear of the documented toxicities associated with didanosine. The most worrisome toxicities include pancreatitis and peripheral neuropathy. With close observation and follow-up, these toxicities can almost always be avoided or easily reversed. This article attempts to allay these fears so that the practitioner can administer this effective antiretroviral confidently and safely. The development of nucleoside and the pharmacology of didanosine are discussed. Drug administration information is provided, including a description of the different forms of didanosine currently available. Guidelines for assessing toxicities associated with didanosine, as well as suggestions for patient education, are also provided. Data gathered at the National Cancer Institute in the phase I didanosine trial indicate that early detection and discontinuation of didanosine, in nearly all cases, can limit or lessen the extent of morbidity.
医学界有报告称，由于担心已记录的与去羟肌苷相关的毒性，成人艾滋病病毒（HIV）患者在使用去羟肌苷时存在犹豫。最令人担忧的毒性包括胰腺炎和周围神经病变。通过密切观察和随访，这些毒性几乎总能避免或很容易逆转。本文试图减轻这些担忧，以便从业者能够自信且安全地使用这种有效的抗逆转录病毒药物。文中讨论了核苷的发展以及去羟肌苷的药理学。提供了给药信息，包括对目前可用的不同形式去羟肌苷的描述。还提供了评估与去羟肌苷相关毒性的指南以及患者教育建议。美国国立癌症研究所一期去羟肌苷试验收集的数据表明，在几乎所有情况下，早期发现并停用去羟肌苷可以限制或减轻发病程度。
