A Pharmacist's Query Avoiding Exacerbation of Adverse Effects in a Patient with Acyclovir Encephalopathy: A Case Report

• Published in: YAKUGAKU ZASSHI Vol. 142; no. 7; pp. 771 - 774
• Main Authors: 渡邊, 政博, 山口, 佳津騎, 黒川, 直弘, 松原, 亜紀, 芳地, 一, 田中, 裕章, 田井, 達也, 小坂, 信二, 新村, 航, 元木, 貴大
• Format: Journal Article
• Language: Japanese
• Published: 公益社団法人 日本薬学会 01.07.2022; Pharmaceutical Society of Japan
• Subjects: acyclovir encephalopathy; adverse effect; pharmacist
• ISSN: 0031-6903; 1347-5231; 1347-5231
• DOI: 10.1248/yakushi.21-00237

We report a haemodialysis patient with end-stage renal failure whom a pharmacist aided in the management of acyclovir (ACV) encephalopathy, which may have been related to valacyclovir hydrochloride (VACV) administered without sufficient dose reduction. The patient 78 years was admitted with a tentative diagnosis of varicella zoster viral meningitis. A pharmacist suspected ACV encephalopathy related to excessive VACV administration and raised a query with the attending physician. According to the pharmacist's proposal, ACV administration was discontinued and continuous hemodiafiltration (CHDF) was performed. On day 5 of hospitalisation, the consciousness disorder was improved. In this report, we showed the detailed CHDF conditions of the present case, and the contribution of a pharmacist to treating and avoiding ACV encephalopathy was discussed.