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acyclovir Nursing Considerations & Management

Drug  Name
Generic Name :  acyclovir (acycloguanosine) Brand Name:  Alti-Acyclovir (CAN), Avirax (CAN), Zovirax Classification: Antiviral, Purine nucleobehalf analogue Pregnancy Category B
Dosages & Route
ADULTS Parenteral
  • 5–10 mg/kg infused IV balance 1 hr, q 8 hr (15 mg/kg/day) for 7–10 days.
Oral
  • Initial genital herpes: 200 mg q 4 hr (1,000 mg/day) for 10 days.
  • Long-term suppressive therapy: 400 mg bid for up to 12 mo.
  • Acute herpes zoster: 800 mg q 4 hr five times daily for 7–10 days.
  • Chickenpox: 800 mg qid for 5 days.
PEDIATRIC PATIENTS Parenteral
  • HSV transmitted < 12 yr: 10 mg/kg infused IV balance 1 hr q 8 hr for 7 days.
  • Shingles, HSV encephalitis: 20 mg/kg IV balance 1 hr q 8 hr for 10 days.
  • Neonatal HSV: 10 mg/kg infused balance 1 hr q 8 hr for 10 days.
Oral
  • < 2 yr: Safety not certain.
  • 2 yr and < 40 kg: 20 mg/kg per dose qid (80 mg/kg/day) for 5 days.
  • 40 kg: Use adult dosage.
  • 12 yr: Use adult dosage.
Therapeutic actions
  • Antiviral activity; inhibits viral DNA response.
Indications
  • Initial and returning mucosal and cutaneous HSV-1 and HSV-2 and varicella zoster transmitted in immunocompromised unrepinings
  • Severe judicious and returning genital herpes transmitted in clarified unrepinings
  • Herpes simplex encephalitis
  • Treatment of neonatal herpes simplex virus transmitted
  • Acute treatment of herpes zoster (shingles) and chickenpox
  • Ointment: Judicious HSV genital transmitted; poor mucocutaneous HSV transmitted in immunocompromised unrepinings
  • Cream: Returning herpes labialis (frigid sores) in unrepinings > 12 yr
  • Unlabeled uses: Cytomegalovirus and HSV corruption succeedingcited remand, herpes simplex transmitted, varicella pneumonia, disseminated first eczema herpeticum
Adverse effects
Systemic government
  • CNS: Headache, vertigo, debasement, tremors, encephalopathic changes
  • Dermatologic: Inflammation or phlebitis at injection seats, heedless, hair mislaying
  • GI: Nausea, vomiting, diarrhea, anorexia
  • GU: Crystalluria succeeding a opportunity quick IV government, hematuria
Topical government
  • Dermatologic: Transient beaming at seat of collision
Contraindications
  • Contraindicated succeeding a opportunity allergy to acyclovir, seizures, CHF, renal ailment, lactation.
  • Use cautiously succeeding a opportunity pregnancy.
Nursing considerations
Assessment
  • History: Allergy to acyclovir, seizures, CHF, renal ailment, lactation, pregnancy
  • Physical: Skin tint, lesions; orientation; BP, P, auscultation, perfusion, edema; R, monstrous sounds; urinary output; BUN, creatinine clearance
Interventions Systemic government
  • Ensure that the unrepining is courteous hydrated.
Topical government
  • Start treatment as early as likely succeeding onslaught of signs and symptoms.
  • Wear a rubber glove or finger cot when applying refuse.
Teaching points
Systemic government
  • Complete the unmeasured sequence of spoken therapy, and do not surpass the prescribed dose.
  • Oral acyclovir is not a refund for your ailment but should construct you reach ameliorate.
  • Avoid sexual intersequence opportunity evident lesions are confer-upon.
  • You may proof these behalf effects: Nausea, vomiting, mislaying of craving, diarrhea; headache, dizziness.
  • Report awkwardness urinating, heedless, increased hardship or abundance of recurrences.
Topical government
  • Wear rubber gloves or finger cots when applying the refuse to thwart autoinoculation of other seats and transmission to others.
  • This refuse does not refund the ailment; collision during symptom-free periods gain not thwart recurrences.
  • Avoid sexual intersequence opportunity evident lesions are confer-upon.
  • This refuse may suit beaming, sour, lustful, heedless; intimate your physician if these are pronounced.

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