Donna Cederberg

Research Triangle Park Foundation

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John Mills

AgResearch

Donna Mildvan

Icahn School of Medicine at Mount Sinai

Mark Z. Jacobson

Stanford University

P de Miranda

AstraZeneca (United States)

Thimysta C. Burnette

Rega Institute for Medical Research

Stuart Handwerger

Cincinnati Children's Hospital Medical Center

Juan Orellana

Pontificia Universidad Católica de Chile

Martin Blum

University of Hohenheim

Usha Mathur‐Wagh

Cornell University

H R Brodie

Western General Hospital

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University of California, San Francisco

Burroughs Wellcome Fund

Research Triangle Park Foundation

Mount Sinai Beth Israel

Icahn School of Medicine at Mount Sinai

San Francisco General Hospital

Triangle

University of Wisconsin–Madison

Cornell University

Cancer Research Center

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Treatment of Cytomegalovirus Retinitis in Patients with AIDS

Clinical Infectious Diseases (1988)

John Mills Mark Z. Jacobson James J. O’Donnell Donna Cederberg Gary N. Holland

Retinitis is the commonest clinical manifestation of cytomegalovirus (CMV) infection in patients with AIDS. Untreated patients generally experience progressive involvement of the retina, which may result in blindness. Attempts to treat this condition with vidarabine and interferon-a have been uniformly unsuccessful. Therapy with ganciclovir (9[(1,3dihydroxy- 2-propoxy)methyl]guanine) (7.5–15 mg/[kg·/d] given intravenously in two or three divided doses) has been shown to halt progression of retinitis and may result in limited healing in some cases; viremia and shedding of virus from other sites (such as the urine) are halted or reduced. However, reactivation of infection and retinitis usually occurs when ganciclovir therapy is discontinued. For that reason, most patients have received continued therapy with the drug, most commonly at a dosage of 5–6 mg/(kg·d) administered as a single intravenous infusion 5–7 days per week. Both retrospective and prospective, randomized trials have shown that maintenance therapy delays (but does not prevent) reactivation of infection. Much more limited studies with foscarnet (trisodium phosphonoformate) suggest that this drug will also be useful for treatment of CMV retinitis in AIDS patients. Further research is needed, however, since existing agents have a low therapeutic ratio and cannot be given orally to patients requiring long-term maintenance therapy.

Cytomegalovirus retinitis

AIDS-Related Opportunistic Infections

Cytomegalovirus

Cytomegalovirus infections

10.1093/clinids/10.supplement_3.s522

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Citations (40)

Pharmacokinetics of the acyclovir pro-drug valaciclovir after escalating single-and multiple-dose administration to normal volunteers

Clinical Pharmacology & Therapeutics (1993)

S Weller Martin Blum M Doucette Thimysta C. Burnette Donna Cederberg

The pharmacokinetics and safety of the L-valyl ester pro-drug of acyclovir, valaciclovir (256U87), were investigated in two phase I, placebo-controlled trials in normal volunteers. These included a single-dose study with doses from 100 to 1000 mg (single cohort) and a multiple-dose investigation with doses from 250 to 2000 mg (five separate cohorts). In each cohort, eight subjects received valaciclovir and four subjects received placebo. Pharmacokinetic findings for valaciclovir and acyclovir were consistent in the two studies. Valaciclovir was rapidly and extensively converted to acyclovir, resulting in significantly greater acyclovir bioavailability (~ threefold to fivefold) compared with that historically observed with high-dose (800 mg) oral acyclovir. At the higher valaciclovir doses, acyclovir maximum concentration and daily area under the concentration-time curve approximated those obtained with intravenous acyclovir. The favorable safety profile and enhanced acyclovir bioavailability from valaciclovir administration has prompted additional clinical evaluations for zoster and herpes simplex virus treatment, as well as cytomegalovirus suppression in immunocompromised patients. Clinical Pharmacology and Therapeutics (1993) 54, 595–605; doi:10.1038/clpt.1993.196

Valaciclovir

Penciclovir

Aciclovir

10.1038/clpt.1993.196

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Citations (389)

Allopurinol: Intravenous Use for Prevention and Treatment of Hyperuricemia

Journal of Clinical Oncology (2000)

Richard V. Smalley Al Guaspari Sandra Haase-Statz Susan Anderson Donna Cederberg

PURPOSE: To tabulate data obtained over a 21-year period to determine the efficacy and safety of an intravenous (IV) allopurinol preparation. PATIENTS AND METHODS: IV allopurinol was provided on a compassionate plea basis to patients of any age in whom xanthine oxidase inhibitor therapy was indicated as an adjunct to chemotherapy and for whom oral intake was restricted. Three hundred twenty-seven investigators at multiple hospitals in the United States treated 1,172 patients with IV allopurinol. The vast majority of these patients had a malignancy and were in danger of developing tumor lysis syndrome (TLS) and subsequent acute uric acid nephropathy (AUAN) and were unable to take oral allopurinol. Data referable to the time period of IV allopurinol administration were collected, collated, and analyzed retrospectively. There was no randomization. RESULTS: In patients initiating treatment for an elevated serum uric acid (SUA), the SUA normalized or improved in 87% of adult patients and normalized or improved in 95% of pediatric patients. IV allopurinol, administered prophylactically to patients at high risk of developing hyperuricemia and TLS, prevented an increase in SUA levels in 93% of adults and 92% of children. Toxicities caused by IV allopurinol were minimal and consisted of 10 instances of mild to moderate skin or allergic reactions. CONCLUSION: IV allopurinol is as efficacious and safe as oral allopurinol and will be of significant benefit to patients at risk of TLS and AUAN and unable to take oral medication.

Allopurinol

10.1200/jco.2000.18.8.1758

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Citations (106)

For a nursing career, prepare to play many parts

Nursing Management (1986)

Donna Cederberg

DONNA M. CEDERBERG, MSN, RN, for three years a Clinical Coordinator, Specialty Units at Wilson Memorial Hospital, is now Clinical Research Scientist, Burroughs Wellcome Co., Research Triangle Park, North Carolina.

10.1097/00006247-198604000-00022

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Citations (1)

Treatment of cytomegalovirus retinitis with ganciclovir (9-[2-hydroxy-1-(hydroxymethyl) ethoxymethyl] guanine (BW B759U).

British Journal of Ophthalmology (1988)

Juan Orellana Steven Teich Jacqueline Winterkorn Usha Mathur‐Wagh Stuart Handwerger

Six patients (11 eyes) with virologically confirmed cytomegalovirus (CMV) retinitis involving the posterior pole of the eye were treated with a new drug, ganciclovir. Treatment with intravenous ganciclovir consistently halted progression of retinitis and produced improvement in measures of visual function. However, within three weeks after cessation of therapy renewed CMV activity and worsening of visual function were observed in most cases. Maintenance therapy with ganciclovir extended the period of remission from CMV retinitis.

Cytomegalovirus retinitis

Cytomegalovirus

Maintenance therapy

Hydroxymethyl

10.1136/bjo.72.7.525

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Citations (11)

Breast Cancer? Let Me Check My Schedule!

Routledge eBooks (2019)

Erma Bombeck Donna Cederberg D Davidson Joy Edwards Carol Hebestreit

They come from different backgrounds and from professions as varied as medicine, education, and entertainment, but these ten women share one thing in common: They all have breast cancer. This book describes their experiences, exploring their initial fear, rage, and uncertainty, and reveals how each eventually coped, in her own way, with her diagnos

10.4324/9780429040450

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Citations (9)

Ganciclovir for the treatment and suppression of serious infections caused by cytomegalovirus

The American Journal of Medicine (1987)

Oscar L. Laskin Donna Cederberg John Mills Lawrence J. Eron Donna Mildvan

Leukopenia

Cytomegalovirus

Foscarnet

10.1016/0002-9343(87)90685-1

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Citations (165)

Human pharmacokinetics and tolerance of oral ganciclovir

Antimicrobial Agents and Chemotherapy (1987)

Mark Z. Jacobson P de Miranda Donna Cederberg Thimysta C. Burnette E K Cobb

Ganciclovir is a nucleoside analog which inhibits the replication of herpesviruses in vitro and which has been effective by intravenous administration for the treatment of severe cytomegalovirus infection in immunocompromised patients. Because most patients with acquired immunodeficiency syndrome and severe cytomegalovirus infection have required lifelong daily suppressive ganciclovir therapy to control disease progression, oral therapy appears to have practical advantages. We studied the pharmacokinetics of orally administered ganciclovir in four patients with acquired immunodeficiency syndrome and cytomegalovirus retinitis. Repeated oral ganciclovir doses (10 to 20 mg/kg every 6 h) were well tolerated. With a 20-mg/kg dose given every 6 h, mean steady-state peak and trough levels were 2.96 and 1.05 microM, respectively, and the area under the concentration-time curve from 0 to 24 h was 47 microM X h. Calculated absorption was 3.0%, based on urinary excretion. Because the levels achieved in serum with oral ganciclovir approximated those required to inhibit cytomegalovirus in vitro, a trial of oral maintenance therapy in immunocompromised patients with severe cytomegalovirus infections seems warranted.

Cytomegalovirus

10.1128/aac.31.8.1251

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Citations (92)