USMLE

Acyclovir

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Anti-Infective Drugs
  1. Vancomycin
  2. Metronidazole
  3. Penicillins
  4. Cephalosporins
  5. Macrolides
  6. Fluoroquinolones
  7. Aminoglycosides
  8. Tetracyclines
  9. Sulfonamides
  10. Rifampin
  11. Isoniazid
  12. Ethambutol
  13. Chloroquine
  14. Acyclovir
  15. Oseltamivir
  16. Azoles
  17. Nystatin
  18. Amphotericin B

Summary

Acyclovir is an antiviral medication that is used to treat herpes simplex virus as well as the varicella-zoster virus. A major adverse effect of acyclovir is nephrotoxicity, so questions containing patients with abnormal BUN, creatinine, and urine output should cause concern for the patient’s safety. To prevent kidney injury, make sure the infusion rate is set within the appropriate limits and make sure the patient is drinking plenty of fluids.

Key Points

  • Acyclovir
    • Related drugs include famciclovir and valacyclovir
    • Mechanism
      • Antiviral
        • Inhibits viral DNA synthesis by inactivating the viral DNA polymerase
      • Can be given oral or IV
    • Clinical Use
      • Herpes simplex virus
        • Genital and oral herpes
          • Acyclovir will help the lesions to dry and crust over, but will not eradicate the virus
      • Varicella-zoster viruses
        • Chickenpox or shingles
    • Side Effects and Adverse Reactions
      • Nephrotoxicity
        • Higher risk with older patients
        • Risk is decreased by taking plenty of fluids
        • Closely monitor BUN, creatinine, and urine output
        • Can be minimized by infusing IV acyclovir at a slow rate
      • GI distress (nausea, vomiting, diarrhea)
      • Headache
      • Rash, pruritus
      • Hematuria
      • Blood dyscrasias