Acyclovir ointment is used to treat first outbreaks of genital herpes (a herpes virus infection that causes sores to form around the genitals and rectum from time to time) and to treat certain types of sores caused by the herpes simplex virus in people with weak immune systems.
Full Answer
What is acyclovir used for?
For which clients would treatment with acyclovir be most clearly indicated A 44 | Course Hero. For which clients would treatment with acyclovir be most clearly indicated A 44 from NUR 3420 at Madonna University. Study Resources.
When is the best time to take acyclovir?
Jun 28, 2021 · Acyclovir is a medication used in the management and treatment of infections caused by the herpes simplex virus (HSV). It is FDA approved to treat genital herpes and HSV encephalitis. Some off-label uses include cold sores, shingles, and chickenpox. It is in the antiviral class of medications. This activity outlines the indications, action, pharmacology, and …
What does the nurse say about acyclovir in older patients?
Feb 26, 2021 · -Oral acyclovir therapy should be considered an alternative therapy to treat acute localized dermatomal herpes zoster in HIV-infected adults according to the Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents; IV acyclovir is preferred therapy with extensive cutaneous lesion or visceral involvement.
Which drug is prescribed to a 45-year-old client for genital herpes?
For which clients would treatment with acyclovir be most clearly indicated? A 77-year-old whose recent debilitating pain has been attributed to a herpes zoster infection A patient being treated for HIV with saquinavir informs the nurse they he has been "suffering from depression" and taking St. John's wort to help.
What client is most vulnerable to infection with cytomegalovirus?
However, doctors consider the possibility of CMV infection in the following people:Otherwise healthy people who have fever and fatigue.People who have a weakened immune system. ... Newborns who seem sick.
Which adverse effects should the nurse monitor for in a client receiving acyclovir?
Patients should be monitored for adverse effects such as malaise, inflammation or phlebitis at the infusion site, nausea, vomiting, rash (including Steven-Johnson syndrome), transaminitis, nausea, vomiting, diarrhea, headache, abdominal pain, aggression/confusion, agitation, alopecia, anaphylaxis, anemia, angioedema, ...Jun 28, 2021
What are the common adverse effects of antivirals that the nurse needs to assess for?
Adverse EffectsCNS: dizziness, blurred vision, headache.GI: dry mouth, constipation or diarrhea, nausea, abdominal pain, dyspepsia.Flu-like syndrome may occur but this may also be because of the underlying disease.Feb 12, 2021
In which of the following patients is the use of cidofovir contraindicated?
Cidofovir therapy is contraindicated in patients with baseline renal disease, renal impairment, or renal failure defined as a serum creatinine concentration > 1.5 mg/dl or calculated creatinine clearance <= 55 ml/min and in those who have >= 2+ proteinuria (urine protein >= 100 mg/dl).
What should I monitor with acyclovir?
Consider monitoring renal function. Possible increased incidence of adverse CNS effects (coma, confusion, hallucinations, somnolence), GI effects (nausea, vomiting), or dizziness during oral acyclovir therapy compared with younger adults.Jun 21, 2021
What adverse effect is intravenous acyclovir known to cause?
redness or swelling at the injection site. nausea. vomiting.Nov 15, 2016
What are the most common adverse effects associated with drug therapy?
Some common examples mild adverse effects related to drugs include:Constipation.Skin rash or dermatitis.Diarrhea.Dizziness.Drowsiness.Dry mouth.Headache.Insomnia.More items...
What can the nurse do to maximize a patient's adherence to the medication regimen?
The following are ten strategies that providers can use to boost medication compliance.Understand each patient's medication-taking behaviors. ... Talk about side effects. ... Write it down. ... Collaborate with patients. ... Consider the financial burden to the patient. ... Assess health literacy. ... Reduce complexity. ... Follow up with patients.More items...•Jan 22, 2020
For what viruses might the nurse administer acyclovir an antiviral?
Indications: Acyclovir (Zovirax) and its derivatives are frequently used for the treatment of herpes and varicella virus infections, including genital herpes, chickenpox, shingles, Epstein-Barr virus infections, and cytomegalovirus infections.
Which of the following is a side effect of cidofovir?
Common side effects of Vistide include nausea, vomiting, diarrhea, loss of appetite, white patches or sores inside your mouth or on your lips, headache, skin rash, hair loss, or cough.
How is cidofovir administered?
The recommended dose of cidofovir is 5 mg/kg body weight (given as an intravenous infusion at a constant rate over 1 hour) administered once weekly for two consecutive weeks.
Why is cidofovir given with probenecid?
Concomitant oral probenecid decreases both the renal clearance of cidofovir and the incidence of nephrotoxicity, presumably by blocking its active tubular secretion. This is the basis of the clinical use of concomitant probenecid as a nephroprotectant during cidofovir therapy.
Usual Adult Dose For Herpes Simplex - Mucocutaneous/Immunocompetent Host
Treatment of First Episode of Genital Herpes:200 mg orally every 4 hours 5 times a day for 10 days (manufacturer dosing)400 mg orally 3 times a day...
Usual Adult Dose For Herpes Simplex - Mucocutaneous/Immunocompromised Host
Concomitant HIV infection:-Treatment of First Episode of Genital Herpes:400 mg orally 3 times a day for 5 to 10 days (guideline recommendation)Dura...
Usual Adult Dose For Herpes Simplex Encephalitis
10 mg/kg IV every 8 hoursDuration of therapy: 10 days (manufacturer); 21 days (CDC)Comments:-The Center for Disease Control and Prevention (CDC) re...
Usual Adult Dose For Herpes Zoster
800 mg orally every 4 hours 5 times a day for 7 to 10 daysImmunocompromised host:10 mg/kg IV every 8 hours for 7 daysConcomitant HIV infection:-Loc...
Usual Adult Dose For Varicella-Zoster
Immunocompetent Host: 800 mg orally 4 times a day for 5 daysImmunocompromised Host: 10 mg/kg IV every 8 hours for 7 daysHIV-Infected Adults:-Uncomp...
Usual Adult Dose For Herpes Simplex Labialis
Immunocompetent host:Apply 50 mg (1 buccal tablet) as a single-dose to the upper gum region (canine fossa)Comments:-Tablet should be applied within...
Usual Adult Dose For Herpes Simplex - Suppression
Daily Suppressive Therapy for Recurrent Disease: 400 mg orally 2 times a day-Alternative regimens from 200 mg orally 3 times a day to 200 mg orally...
Usual Adult Dose For Herpes Zoster - Prophylaxis
HIV-Infected Adults (guideline dosing):-Post-Exposure Prophylaxis: 800 mg orally 5 times a day for 5 to 7 days; begin 7 to 10 days after exposureCo...
Usual Pediatric Dose For Herpes Simplex - Congenital
Neonatal Herpes:Birth to 3 months: 10 mg/kg IV every 8 hours for 10 days (manufacturer dosing)Birth to 3 months: 20 mg/kg IV every 8 hours (CDC rec...
Usual Pediatric Dose For Herpes Simplex - Mucocutaneous/Immunocompetent Host
Treatment of First Episode of Genital Herpes:Less than 12 years: 40 to 80 mg/kg/day orally in divided doses 3 to 4 times a day for 5 to 10 daysMaxi...
What does the physician prescribe to an immigrant?
b. An immigrant and his wife are both HIV positive. The physician prescribes antiretroviral medications. However, the client, tell the nurse he is concerned about his ability to afford the treatment.
What is a nursing student studying?
Nursing students are studying antiviral drug therapy in a pharmacology class. A student asks the instructor to explain why multi-drug regimens are used to treat HIV infections. The instructor responds that drug combinations are often prescribed because they. A. decrease the length of illness.
How long does valacyclovir last?
800 mg orally every 4 hours 5 times a day for 7 to 10 days#N#Immunocompromised host:#N#10 mg/kg IV every 8 hours for 7 days#N#Concomitant HIV infection:#N#-Localized Dermatomal: 800 mg orally 5 times a day for 7 to 10 days (alternative therapy; oral valacyclovir or famciclovir are preferred therapy)#N#-Extensive Cutaneous Lesion or Visceral Involvement: 10 to 15 mg/kg IV every 8 hours until clinical improvement (i.e. no new vesicle formation or improvement of signs and symptoms of visceral disease), then switch to oral therapy#N#Duration of therapy: 7 to 14-day course (oral plus IV)#N#Comments:#N#-Treatment should be initiated as soon as possible after a diagnosis of herpes zoster; parenteral dosing is based on ideal body weight (IBW).#N#-Oral acyclovir therapy should be considered an alternative therapy to treat acute localized dermatomal herpes zoster in HIV-infected adults according to the Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents; IV acyclovir is preferred therapy with extensive cutaneous lesion or visceral involvement.#N#Use: For the acute treatment of herpes zoster (shingles).
What is the best treatment for herpes simplex?
-Acyclovir is the drug of choice for local and disseminated herpes simplex in HIV-infected and exposed infants and children; children with severe immunosuppression and moderate to severe lesions should be treated initially with IV therapy and may require longer therapy.
How long does it take to get rid of herpes?
Treatment of First Episode of Genital Herpes: Less than 12 years: 40 to 80 mg/kg/day orally in divided doses 3 to 4 times a day for 5 to 10 days. Maximum dose: 1000 mg/day. 12 years or older: 200 mg orally every 4 hours 5 times a day OR 400 mg orally 3 times a day. Duration of therapy: 7 to 10 days.
How long does it take to take a 20 mg med?
-Mild disease with no or moderate immune suppression (CDC immunologic category 1 and 2): 20 mg/kg orally 4 times a day for 7 to 10 days and until no new lesions for 48 hours. Maximum dose: 800 mg.
How long does it take for genital herpes to heal?
Concomitant HIV infection:#N#-Treatment of First Episode of Genital Herpes:#N#400 mg orally 3 times a day for 5 to 10 days (guideline recommendation)#N#Duration of therapy: 5 to 10 days#N#-Severe Disease:#N#5 mg/kg IV every 8 hours after lesions begin to regress, may change to oral therapy; continue treatment until lesions have completely healed (guideline recommendation)#N#Episodic (Intermittent) Therapy: Effective treatment requires therapy initiation within 1 day of lesion onset or during the prodrome preceding an episode/recurrence#N#400 mg orally 3 times a day for 5 to 14 days#N#Comments:#N#-Immunocompromised patients can have prolonged or severe episodes of genital, perianal, or oral herpes.#N#-Clinical manifestations of genital herpes may worsen during immune reconstitution early after initiation of antiretroviral therapy.#N#-Suppressive or episodic therapy with oral antiviral agents is effective in decreasing the clinical manifestations of HSV in persons with HIV infection.#N#-Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV- Infected Adults and Adolescents may be consulted for additional guidance.#N#Use: For the treatment of initial and recurrent mucosal and cutaneous herpes simplex (HSV-1 and HSV-2) in immunocompromised patients.
Diagnostic Considerations
Clinical diagnosis of genital herpes can be difficult because the self-limited, recurrent, painful, and vesicular or ulcerative lesions classically associated with HSV are absent in many infected persons at the time of clinical evaluation.
Genital Herpes Management
Antiviral medication offers clinical benefits to symptomatic patients and is the mainstay of management. The goals for use of antiviral medications to treat genital herpes infection are to treat or prevent symptomatic genital herpes recurrences and improve quality of life and suppress the virus to prevent transmission to sexual partners.
Hepatitis
Hepatitis is a rare manifestation of disseminated HSV infection, often reported among pregnant women who acquire HSV during pregnancy ( 484 ). Pregnant women in any trimester can present with fever and hepatitis (markedly elevated transaminases) but might not have any genital or skin lesions.
Prevention
Consistent and correct condom use has been reported in multiple studies to decrease, but not eliminate, the risk for HSV-2 transmission from men to women ( 486 – 488 ). Condoms are less effective for preventing transmission from women to men ( 489 ).
Counseling
Counseling of persons with genital herpes and their sex partners is crucial for management. The goals of counseling include helping patients cope with the infection and preventing sexual and perinatal transmission.
Management of Sex Partners
The sex partners of persons who have symptomatic genital herpes can benefit from evaluation and counseling. Symptomatic sex partners should be evaluated and treated in the same manner as patients who have symptomatic genital herpes.
Special Considerations
Allergic and other adverse reactions to oral acyclovir, valacyclovir, and famciclovir are rare. Desensitization to acyclovir has been described ( 500 ).
When to start taking acyclovir?
If you are taking acyclovir for the treatment of chickenpox, it is best to start taking acyclovir as soon as possible after the first sign of the chickenpox rash, usually within one day.
How long does acyclovir last?
The usual dose is 5 to 10 mg of acyclovir per kg (2.3 to 4.5 mg per pound) of body weight, injected slowly into a vein over at least a one-hour period, and repeated every eight hours for five to ten days. Children up to 12 years of age—Dose is based on body weight and must be determined by the doctor.
How old do you have to be to take a shingles shot?
Children up to 12 years of age—Use and dose must be determined by the doctor. For injection dosage form: For treatment of herpes of the brain, genitals, or mucous membranes, or for the treatment of shingles: Adults and children 12 years of age and older—Dose is based on body weight and must be determined by the doctor.
How much chickenpox is 800 mg?
The usual dose is 20 mg per kilogram (kg) of body weight, up to 800 mg, ...
How long does a child have to take a syringe?
Children up to 2 years of age—Use and dose must be determined by the doctor. Adults and children 12 years of age and older—800 mg five times a day for seven to ten days. Children up to 12 years of age—Use and dose must be determined by the doctor.
Can you miss acyclovir?
Do not miss any doses. However, do not use this medicine more often or for a longer time than your doctor ordered. If you are taking acyclovir capsules, tablets, or oral suspension, you should drink plenty of water to avoid becoming dehydrated.
What is combination therapy?
Use of combination therapy attacks the virus at different stages of the life cycle. A student nurse, under the supervision of a preceptor, is caring for a patient who is receiving ganciclovir. The preceptor asks the student to identify potential adverse effects of the drug.
Can CMV cause muscle stiffness?
CMV-IGIV can cause injection site pain and tenderness, muscle stiffness, headache, chills, and fever. The nurse is providing health education to a client who has recently been diagnosed with HIV and will soon begin antiretroviral therapy.