Acyclovir

Brand Name: Avirax, Zovirax

Classification: Antiviral, purine analogues

Indications

• Recurrent genital herpes infection (PO)
• Localized cutaneus herpes zoster infection (shingles) – PO
• Chickenpox (varicella) – PO
• Severe initial episodes of genital herpes in nonimmunosuppressed patients – IV
• Herpes simplex encephalitis
• Recurrent herpes labialis (cold sores) – topical
• Acute mucocutaneous HSV infections in immunocompromised patients

Mechanism of Action

Acyclovir interferes with viral DNA synthesis. Thus, it inhibits viral replication, decreased viral shedding and reduces time for healing of lesions.

Contraindications

• Hypersensitivity

Use cautiously in patients with the following conditions:

• Pre-existing serious neurologic, hepatic, pulmonary or fluid and electrolyte abnormalities
• Renal impairment
• Geriatric patients
• Obese patients
• Pregnancy and lactation

Side Effects

• Dizziness
• Headache
• Trembling
• Diarrhea
• Nausea
• Vomiting
• Abdominal pain
• Anorexia
• Acne
• Hives
• Unusual sweating
• Pain
• Phlebitis
• Local pain
• Irritation (local)

Nursing Interventions

1. Assess lesions before and daily during therapy.
2. Shake the liquid well before each use to mix the medication evenly. (for suspension preparation)
3. Acyclovir can be taken with or without food with a full glass of water.
4. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.
5. Take acyclovir until you finish the prescription, even if you feel better. If you stop taking acyclovir too soon or skip doses, your infection may not be completely treated or may become more difficult to treat.
6. Acyclovir treatment should be started as soon as possible after herpes simplex symptoms appear and within 24 hours of a herpes zoster break.
7. For IV preparations, the infusion site should be observed for phlebitis. The infusion site should be rotated to prevent phlebitis.
8. Watch out for signs of acyclovir overdose which are:

• Agitation
• Seizures
• Extreme tiredness
• Loss of consciousness
• Swelling of the hands, feet, ankles or lower legs
• Decreased urination

image courtesy of bedfordlabs.com