A female client with herpes zoster is prescribed acyclovir (Zovirax), 200 mg P.O. every 4 hours while awake. The nurse should inform the client that this drug may cause:
A. Palpitations
B. Dizziness
C. Diarrhea
D. Metallic taste
Correct Answer: C. Diarrhea
Oral acyclovir may cause such adverse GI effects as diarrhea, nausea, and vomiting. It isn’t associated with palpitations, dizziness, or a metallic taste. Acyclovir is an antiviral agent that incorporates itself into viral DNA preventing further synthesis. It inhibits DNA synthesis and viral replication after it is converted to acyclovir triphosphate by viral and cellular enzymes. Patients also may experience nausea, vomiting, diarrhea, headache when taken orally.
Option A: Less commonly, patients experience inflammation or phlebitis at the infusion site, nausea, vomiting, transaminitis, and rash (including Steven-Johnson syndrome) when taken intravenously. Rotating infusion sites and decreasing final infusion concentration less than 10 mg/mL can help prevent inflammation/phlebitis at the infusion site.
Option B: Least commonly, patients experience abdominal pain, aggression/confusion, agitation, alopecia, anaphylaxis, anemia, angioedema, anorexia, ataxia, coma, disseminated intravascular coagulation (DIC), dizziness, and fatigue.
Option D: Acute kidney injury (AKI) is the most significant side effect of parenteral acyclovir administration. The incidence of AKI is comparable to other nephrotoxic medications such as aminoglycosides. Patients with CKD are at higher risk.
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