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Internal Medicine

Answer 6
  1. All of the above (in patients older than age 75 years, in patients with creatinine levels greater than 1.5 mg/dL, in patients with hepatic dysfunction, in patients with platelet counts less than 100,000/mm3). Oral antiviral medications have a very good safety record, with remarkably few side effects or adverse events associated with their use. In addition, oral antiviral medications may be used regardless of patient age. In contrast, use of intravenous acyclovir has been associated with acute renal failure, particularly when underlying renal insufficiency is present. Intravenous acyclovir has caused thrombotic thrombocytopenic purpura/hemolytic-uremic syndrome in immunosuppressed patients and should be used with caution in patients with hepatic abnormalities.

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