A patient with CMV retinitis is started on ganciclovir. Which adverse effect requires monitoring with complete blood counts and is the major dose-limiting toxicity?

• A Pancreatitis
• B Retinal detachment
• C Peripheral neuropathy
• D Bone marrow suppression (neutropenia, thrombocytopenia) ✓

Explanation

Ganciclovir causes dose-dependent bone marrow suppression, primarily neutropenia and thrombocytopenia, requiring regular CBC monitoring. Retinal detachment is a complication of CMV retinitis itself, not ganciclovir. Peripheral neuropathy is associated with NRTIs like stavudine. Pancreatitis is associated with didanosine. Foscarnet, an alternative CMV drug, causes nephrotoxicity instead.

Reference: Katzung's Basic and Clinical Pharmacology, 15th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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