Thursday, 3 April 2025

P SHINGLES X ACICLOVIR AFTER 72 HRS

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Shingles Treatment with Aciclovir (Acyclovir)

1. Indication:
Aciclovir is an antiviral medication used to treat herpes zoster (shingles), caused by reactivation of the varicella-zoster virus. Early treatment helps reduce pain, severity, and complications like postherpetic neuralgia (PHN).

2. Dosage & Administration:

  • Adults & Adolescents: 800 mg orally 5 times daily (every 4 hours while awake) for 7 days.

  • Immunocompromised Patients: IV aciclovir (10 mg/kg IV every 8 hours for 7-10 days) may be required.

  • Renal Impairment: Dose adjustment is necessary.

3. Mechanism of Action:
Aciclovir inhibits viral DNA replication by targeting viral thymidine kinase, thereby reducing viral spread.

4. Additional Management:

  • Pain Control: NSAIDs, acetaminophen, or opioids if severe.

  • Neuropathic Pain: Gabapentin, pregabalin, or amitriptyline for PHN.

  • Topical Therapy: Calamine lotion or lidocaine patches for symptomatic relief.

  • Corticosteroids: May be considered in severe cases to reduce inflammation.

5. When to Start Treatment:

  • Best initiated within 72 hours of rash onset for optimal efficacy.

  • Still beneficial beyond 72 hours in immunocompromised patients or those with ongoing new lesion formation.

Would you like details on special populations (e.g., pregnancy, elderly)?


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