Question

Genital herpes

J.R. is a 36-year-old white, middle-class woman who has been sexually active with one partner for the past 2 years. She and her partner have no history of STIs, but her partner has a history of fever blisters. She reports genital pain, genital vesicles and ulcers, and fever and malaise for the last 3 days. Examination reveals adenopathy and vaginal and cervical lesions.

1. List the specific goals for treatment for J.R.
2. What drug therapy would you prescribe? Why?
3. What are the parameters for monitoring the success of therapy?
4. Discuss specific education for J.R. based on the diagnosis and prescribed therapy.
5. List one or two adverse reactions for the selected agent that would cause you to change therapy.
6. What, if any, would be the choice for second-line therapy?
7. What OTC or alternative medications would you recommend?
8. What dietary and lifestyle changes should be recommended for this patient?
9. Describe one or two drug-drug or drug-food interactions for the selected agent.

Answer 1

SPECIFIC GOALS OF TREATMENT:

The goals of therapy are to reduce morbidity , to shorten the clinical course of the disease , to prevent complication and changes to prevent recurrences.

DRUG THERAPY:

They antiviral medication like acyclovir , valacyclovir , famicyclovir, have been specifically developed for the treatment of genital herpes.

Why

Genital herpes is caused by a virus called herpes simplex virus. Although antibiotics commonly kill bacteria do not work on virus.

PARAMETERS MONITORING:

Some parameters monitoring during administration acyclovir like ---

1. Monitoring neutrophill count
2. Input and output closely monitored
3. Watch iv site for phlebitis
4. Adequate hydration and slow infusion over 1 hr to prevent crystalization in renal tubules.

SECOND LINE THERAPY:

Suppressive therapy is given. Suppressive therapy reduces the frequency of genital herpes recurrences by 70-80 in patient who have frequent recurrences .

OTC MEDICATION OR ALTERNATIVE THERAPY:

First simple self care may be enough to relieve most discomfort caused by genital herpes. Taking an over the counter pain relieve such as aspirin , acetamenophenon ,ibuprofen.

DIETARY CHANGES :

Eating right food and avoiding certain ingredients may boost immune systems and help body fight off herpes virus.

Avoid high arginine food like turkey breast, pork loin , chicken breast, dairy products, during on outbreak of herpes.

LIFESTYLE CHANGES :

Behavior changes occur ---

1. Avoid sex
2. Use condom during sexual activity
3. Avoid sexual transmission infection like HIV.

DRUG DRUG INTERACTION:

Drug may interact with acyclovir include several medication used to treat bacterial or fungal infection including amphotericin B and antibiotics such as amikacin and gentamycin.

DRUG FOOD INTERACTION:

Acyclovir is taken with meals or an empty stomach . It is best taken with a full glass (8 ounces) of water.