Ganciclovir is used to treat CMV (cytomegalovirus) infections, especially in patients who are immunocompromised.
Ganciclovir is often used in immunocompromised patients with AIDS or HIV, as they are more susceptible to more rare CMV manifestations, such as CMV pneumonitis, retinitis or colitis.
Ganciclovir is a synthetic analog of guanosine, which is phosphorylated by a viral kinase encoded by CMV during infection. This leads to the formation of ganciclovir triphosphate.
Ganciclovir triphosphate, which is formed after processing by CMV, is a competitive inhibitor of nucleotide incorporation into DNA. This leads to disrupted DNA synthesis in the virus.
Ganciclovir triphosphate, which is formed by viral processing of ganciclovir, preferentially inhibits viral DNA polymerases, disrupting viral DNA synthesis.
Patients taking this medication can suffer from serious hematological side effects, such as anemia, thrombocytopenia, neutropenia and granulocytopenia.
This drug is prescribed judiciously, as it can lead to nephrotoxicity in patients, and is renally excreted.
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