Acyclovir
- 영어발음 듣기
Trade Name
Zovirax (primary brand name); generic acyclovir
Classification
Antiviral; nucleoside analogue
Dosage/Route
- * Dosage:
- – Tablets/Capsules: 200 mg, 400 mg, 800 mg
- – Suspension: 200 mg/5 mL
- – IV: 50 mg/mL vials
- – Topical: 5% ointment/cream
- * Route: Oral (PO), intravenous (IV), topical
Usual Dosage
- * Herpes Simplex (Genital, Initial): 400 mg PO 3 times daily (TID) or 200 mg PO 5 times daily for 7-10 days
- * Herpes Simplex (Recurrent): 800 mg PO BID or 400 mg PO TID for 5 days
- * Herpes Zoster (Shingles): 800 mg PO 5 times daily for 7-10 days
- * IV (Severe HSV/VZV): 5-10 mg/kg IV every 8 hours for 5-10 days
- * Topical: Apply to lesions 5-6 times daily for 7 days
Mechanism of Action
Inhibits viral DNA replication by acting as a guanosine analogue. Converted by viral thymidine kinase to acyclovir triphosphate, which competitively inhibits viral DNA polymerase and terminates DNA chain elongation. Effective against herpes simplex virus (HSV) and varicella-zoster virus (VZV)
Side Effects & Adverse Effects
- * Side Effects:
- – PO: Nausea, headache, diarrhea
- – IV: Phlebitis, rash
- – Topical: Burning, stinging
- * Adverse Effects:
- – Nephrotoxicity (IV; crystal precipitation in kidneys)
- – Neurotoxicity (IV; confusion, tremors, seizures, esp. high doses/renal impairment)
- – Rare: Thrombocytopenia, anaphylaxis
Nursing Management (Implications & Teachings)
- * Implications:
- – IV: Infuse over 1 hour (slow to prevent renal damage); hydrate well (1-2 L/day)
- – Monitor renal function (CrCl, BUN) baseline/periodically, esp. IV
- – Assess neuro status (confusion, agitation) with IV use
- – Topical: Wear gloves to apply; avoid eyes
- * Teachings:
- – Take PO with/without food; finish full course
- – Drink plenty of water (esp. IV or high-dose PO)
- – Report flank pain, confusion, or rash
- – Topical: Apply thinly; doesn’t prevent transmission
Indication for This Patient
- * Herpes simplex virus (HSV) infections (genital, mucocutaneous, encephalitis)
- * Varicella-zoster virus (VZV) infections (shingles, chickenpox in immunocompromised)
- * Prophylaxis in immunocompromised patients (e.g., transplant, HIV)
Time
- * Timing:
- – PO: 3-5 times daily (per indication)
- – IV: Every 8 hours
- – Topical: Every 3-4 hours
- * Onset: Symptom relief in 1-2 days; viral shedding reduced sooner
- * Duration: 5-10 days (treatment); suppressive therapy may be chronic
