title: Neurotoxicity of commonly used hepatic drugs.
abstract: Neurologic complications are common side-effects of immunosuppressive medications used in the prevention of graft rejection after organ transplantation. The medications most commonly encountered include the calcineurin inhibitors and mycophenolate mofetil. Depression is the most commonly encountered neurotoxicity; however, severe but rare adverse neurological effects related to these therapies have been reported. Interferons, ribavirin, and protease inhibitors are therapeutic options commonly encountered in the treatment of hepatitis. Nucleoside analogs such as adefovir dipivoxil and entecavir carry significant risks for the development of lactic acidosis and hepatic dysfunction; however, most common adverse effects to these therapies in general are mild. While the mechanisms of action are poorly elucidated, they are discussed along with treatment strategies.
authors.affiliation: Neurological Intensive Care Unit, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Christine L
authors.initials: CL
authors.lastname: Ahrens
authors.affiliation: Neurological Intensive Care Unit, Cleveland Clinic, Cleveland, OH, USA. Electronic address: MANNOE@ccf.org.
authors.forename: Edward M
authors.initials: EM
authors.lastname: Manno
mesh_terms: D006505:Hepatitis / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016031:Liver Transplantation / Q000379:methods; D020258:Neurotoxicity Syndromes / Q000209:etiology*
chemical_list: D007166:Immunosuppressive Agents
keywords: Neurotoxicity; calcineurin inhibitors; chronic hepatitis; depression; immunosuppresants; interferons; protease inhibitors; ribavirin