Acyclovir.pdf - ACTIVE LEARNING TEMPLATE Medication Charity Biddy STUDENT NAME Acyclovir MEDICATION REVIEW MODULE CHAPTER CATEGORY CLASS_Antiviral

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Unformatted text preview: ACTIVE LEARNING TEMPLATE: Medication Charity Biddy STUDENT NAME______________________________________ Acyclovir MEDICATION___________________________________________________________________________ REVIEW MODULE CHAPTER____________ CATEGORY CLASS__Antiviral _____________________________________________________________________ PURPOSE OF MEDICATION Expected Pharmacological Action Inhibition of viral replication, decreased viral shedding, and reduced time for healing of lesions. Therapeutic Use Treatment of genital herpes Complications CNS: seizures, dizziness, HA, hallucinations, trembling GI: diarrhea, nausea, vomiting, ↑ liver enzymes, hyperbilirubinemia, abdominal pain, anorexia GU: Renal Failure, crystalluria, hematuria, renal pain Derm: Stevens-Johnson Syndrome, acne, hives, rash, unusual sweating Endo: changes in menstrual cycle Hemat: THROMBOTIC THROMBOCYTOPENIC PURPURA/HEMOLYTIC UREMIC SYNDROME (HIGH DOSES IN IMMUNOSUPPRESSED PATIENTS) Local: pain, phlebitis, local irritation MS: joint pain Misc: polydipsia Medication Administration Initial Genital Herpes PO: (Adults and Children) 200 mg q 4 hr while awake (5 times/day) for 7–10 days or 400 mg q 8 hr for 7–10 days; maximum dose in children: 80 mg/kg/day in 3–5 divided doses. IV: (Adults and Children) 5 mg/kg q 8 hr or 750 mg/m2 /day divided q 8 hr for 5–7 days. Chronic Suppressive Therapy for Recurrent Genital Herpes PO: (Adults and Children) 400 mg twice daily or 200 mg 3–5 times/day for up to 12 mo. Maximum dose in children: 80 mg/kg/day in 2–5 divided doses. Intermittent Therapy for Recurrent Genital Herpes PO: (Adults and Children) 200 mg q 4 hr while awake (5 times/day) or 400 mg q 8hr or 800 mg q 12 hr for 5 days, start at first sign of symptoms. Maximum dose in children: 80 mg/kg/day in 2–5 divided doses. Contraindications/Precautions Contraindicated in: Hypersensitivity to acyclovir or valacyclovir; Hypersensitivity to milk protein concentrate (buccal only) Use Cautiously in: Pre-existing serious neurologic, hepatic, pulmonary, or fluid and electrolyte abnormalities; Renal impairment (dose alteration recommended if CCr <50 mL/min); Geri: Due to age related ↓ in renal function; Obese patients (dose should be based on ideal body weight); Patients with hypoxia; OB: Lactation: Safety not established. Interactions Drug-Drug Probenecid ↑ blood levels of acyclovir. ↑ blood levels and risk of toxicity from theophylline; dose adjustment may be necessary. ↓ blood levels and may ↓ effectiveness of valproic acid or phenytoin . Concurrent use of other nephrotoxic drugs ↑ risk of adverse renal effects. Zidovudine and IT methotrexate may ↑ risk of CNS side effects. Nursing Interventions Assess lesions before and daily during therapy. Assess frequency of recurrences. Monitor neurologic status in patients with herpes encephalitis. Lab Test Considerations: Monitor BUN, serum creatinine, and CCr before and during therapy. ↑ BUN and serum creatinine levels or ↓ CCr may indicate renal failure. Client Education Evaluation of Medication Effectiveness Crusting over and healing of skin lesions. Decrease in frequency and severity of recurrences. Acceleration of complete healing and cessation of pain in herpes zoster. ACTIVE LEARNING TEMPLATES Take as directed for the full course. Use of additional OTC creams, lotions, ointments may delay healing and spread lesions. This is not a cure, the virus lies dormant in ganglia and will not prevent spread of infection to others. Condoms should be used during sexual contact and no sexual contact when lesions are present. call HCP if symptoms not improved in 7 days. Women should have yearly Pap smears d/t more likely to develop cervical cancer. Therapeutic Procedure  A7 ...
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