Acyclovir accumulation is associated with neurotoxicity.
Risk factors for neurotoxicity:
(1) overdose due to drug dosing error
(2) impaired clearance associated with renal disease
Clinical findings:
(1) altered mental status
(2) myoclonus
(3) encephalopathy
(4) visual hallucinations or delusions
Laboratory findings:
(1) elevated serum concentrations of acyclovir
Differential diagnosis:
(1) viral encephalitis
Hemodialysis is effective for the rapid removal of acyclovir.
