Final answer:
Acyclovir can cause nephrotoxicity by crystallizing in the renal tubules at high IV doses. The prevention includes ensuring proper hydration and adjusting doses according to renal function to minimize the concentration of acyclovir in the kidneys.
Step-by-step explanation:
Acyclovir, a widely used antiviral medication for herpes virus infections, can cause nephrotoxicity when administered intravenously, particularly at high doses. The mechanism by which acyclovir damages the kidneys revolves around its potential to crystallize in the renal tubules, a process similar to the formation of kidney stones from substances like calcium oxalate. This crystallization can obstruct the urinary flow and cause damage to the kidneys. To prevent this adverse effect, maintaining adequate hydration and adjusting doses based on renal function are crucial preventative measures. Ensuring patients are well-hydrated helps to dilute the urine which reduces the risk of acyclovir forming crystals. Monitoring renal function allows for dose adjustments to minimize the concentration of acyclovir in the kidneys, therefore preventing nephrotoxicity.
The overall best practice to mitigate the risk of kidney damage from acyclovir involves applying the following strategies: hydration to avoid crystal formation in the renal tubules and dose adjustment based on kidney function to ensure safe levels of the drug in the body.