Herpes Zoster
2
AntiVirals Pg.1846 Acyclovir (Zovirax) Famciclovir ACTION: inhibit viral DNA replication by interfering with viral DNA polymerase. APPLICATION/INDICATION: Effective against Herpes Simplex 1 and 2 , varicella- zoster, herpes zoster , Epson –Barr virus, and cytomegalovirus. Given topically or orally. NURSING RESPONSIBILITIES: Monitor effectiveness of drug, Monitor Side Effects, Encourage adequate fluid intake, Inform pt. that drug is not a cure for herpes. Herper Zoster (Shingles) ETIOLOGY, EPIDEMIOLOGY and PATHOPHYSIOLOGY: Pg.1850 Viral skin infection. Latent varicella-zoster virus causes chickenpox. After chickenpox remains dormant in dorsal root and cranial nerve ganglion. Usually activated when immune compromised by AIDS, Hodgkin’s disease, cancer. In U.S. 95- 99 % of people 40 and over have antibodies for H.Z. Singles Vaccine (Zostavax) recommended to people over 60. CLINICAL MANIFESTATIONS: Lesions are erythematous vesicles scattered on skin along 1 or 2 adjacent dermatomes. Thoracic distribution most common but also common on neck, face, and in eyes. Vesicles come in various sized and with time become cloudy with purulent fluid. Pain, Itching, Burning, Fever Headache, malaise prior to eruption. Postherpetic Neuralgi - pain for weeks, months, sometimes lifetime after lesions resolve. Itching, buring sharp shooting. DIAGNOSTIC, LAB STUDIES, and MEDICAL MANAGEMENT Diagnosis with physical assessment and history. Test used to identify virus Polymerase Chain Reaction. Treatment aimed at shortening course of virus and preventing/alleviating pain. Antiviral Agents Acyclovir, Famciclovir. Treatment can also include nerve block, tricyclic antidepressants, anticonvulsants for pain. NO cure. Herpes Simplex 1, Herpes Simplex 2 ETIOLOGY, EPIDEMIOLOGY and PATHOPHYSIOLOGY: Pg.1850 (HS1) causes oral lesions or cold soars in approximately 80 % of cases and causes genital lesions in approximately 20 % of cases. (HS2) causes genital lesions in approximately 80 % of cases and cause oral lesions in 20 %. Both are more prevalent in women than men. Virus lives in Nerve root and remains asymptomatic until something triggers an outbreak. Sun, stress and fever are common triggers. CLINICAL MANIFESTATIONS: Lesions are vesicles that are erythematous base and appear in groups. Burning, Stinging, Pain. Lesions last 2-6 weeks. Usually followed by a second group of lesions that are less severe. Lesions contain live virus and can be spread by kissing, oral sex, poor hand hygiene, intercourse. Also: sharing drinks, utensils, toothbrush. Condom use recommended.
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Transcript of Herpes Zoster
AntiVirals Pg.1846 Acyclovir (Zovirax) Famciclovir
ACTION: inhibit viral DNA replication by interfering with viral DNA polymerase. APPLICATION/INDICATION: Effective against Herpes Simplex 1 and 2, varicella-zoster, herpes zoster, Epson –Barr virus, and cytomegalovirus. Given topically or orally. NURSING RESPONSIBILITIES: Monitor effectiveness of drug, Monitor Side Effects, Encourage adequate fluid intake, Inform pt. that drug is not a cure for herpes.
Herper Zoster (Shingles)ETIOLOGY, EPIDEMIOLOGY and PATHOPHYSIOLOGY: Pg.1850Viral skin infection. Latent varicella-zoster virus causes chickenpox. After chickenpox remains dormant in dorsal root and cranial nerve ganglion. Usually activated when immune compromised by AIDS, Hodgkin’s disease, cancer. In U.S. 95-99 % of people 40 and over have antibodies for H.Z. Singles Vaccine (Zostavax) recommended to people over 60.
CLINICAL MANIFESTATIONS:Lesions are erythematous vesicles scattered on skin along 1 or 2 adjacent dermatomes. Thoracic distribution most common but also common on neck, face, and in eyes. Vesicles come in various sized and with time become cloudy with purulent fluid. Pain, Itching, Burning, Fever Headache, malaise prior to eruption. Postherpetic Neuralgi - pain for weeks, months, sometimes lifetime after lesions resolve. Itching, buring sharp shooting.
DIAGNOSTIC, LAB STUDIES, and MEDICAL MANAGEMENTDiagnosis with physical assessment and history. Test used to identify virus Polymerase Chain Reaction. Treatment aimed at shortening course of virus and preventing/alleviating pain. Antiviral Agents Acyclovir, Famciclovir. Treatment can also include nerve block, tricyclic antidepressants, anticonvulsants for pain. NO cure.
Herpes Simplex 1, Herpes Simplex 2 ETIOLOGY, EPIDEMIOLOGY and PATHOPHYSIOLOGY: Pg.1850(HS1) causes oral lesions or cold soars in approximately 80 % of cases and causes genital lesions in approximately 20 % of cases. (HS2) causes genital lesions in approximately 80 % of cases and cause oral lesions in 20 %. Both are more prevalent in women than men. Virus lives in Nerve root and remains asymptomatic until something triggers an outbreak. Sun, stress and fever are common triggers.
CLINICAL MANIFESTATIONS:Lesions are vesicles that are erythematous base and appear in groups. Burning, Stinging, Pain. Lesions last 2-6 weeks. Usually followed by a second group of lesions that are less severe. Lesions contain live virus and can be spread by kissing, oral sex, poor hand hygiene, intercourse. Also: sharing drinks, utensils, toothbrush. Condom use recommended.
DIAGNOSTIC, LAB STUDIES, and MEDICAL MANAGEMENTDiagnosis is made through symptoms and physical appearance of lesions. Identified by Tzanck smear or culture. NO Cure but treated. Antivirals are to speed healing.
