Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Acyclovir is an antiviral drug, a synthetic
nucleoside analogue, that is active against the herpes viruses, including herpes
simplex 1 and 2 (cold sores and
genital herpes), varicella-zoster (shingles and
chickenpox), and Epstein-Barr virus (mononucleosis). Viruses take over living
cells and reproduce themselves, often at the expense of the host cell. The
acyclovir is converted to an active form by the virus itself, and the virus then
uses the active form of acyclovir rather than the nucleoside it normally uses to
manufacture DNA, a critical component of viral replication. Incorporation of
active acyclovir into new viral DNA stops the production of the DNA. Virally
infected cells absorb more acyclovir than normal cells and convert more of it to
the active form, which prolongs its antiviral activity. The FDA approved
acyclovir in March 1982.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS:
Capsules: 200 mg.
Tablets: 400 and 800 mg.
Suspension:
200 mg/5 ml.
Injection: 50 mg/ml.
Powder for injection: 500 and 1000 mg.
Ointment 5%.
STORAGE: Acyclovir should be stored at room temperature, between 15-25
C (59-77 F).
PRESCRIBED FOR: Oral Acyclovir is used for treating genital herpes,
herpes zoster, and chickenpox. Acyclovir reduces the pain and the number of
lesions in the initial case of genital herpes, and decreases the frequency and
severity of recurrent infections. In the treatment of shingles, acyclovir
reduces pain, shortens the healing time, and limits the spread of virus and the
formation of new lesions. Acyclovir can be used to treat chicken pox and acts to
reduce healing time, limit the number of lesions, and reduce fever if used
within the first 24 hours after the onset of illness. Intravenous acyclovir is
used for treating herpes simplex and chicken pox in immuno-compromised patients
and severe genital herpes. Acyclovir ointment is used topically to treat initial
genital herpes where it has been shown to decrease pain, reduce healing time,
and limit the spread of the infection.
DOSING: Acyclovir may be taken with or without food. Adult oral doses
are 200 mg to 800 mg every 4 hours (5 times daily). The usual adult intravenous
dose is 5-10 mg/kg every 8 hours for 7 days.
DRUG INTERACTIONS: Acyclovir may decrease levels of phenytoin
(Dilantin) or
valproic acid (Depakote,
Depakote ER). Probenecid
(Benemid) may increase acyclovir serum levels by decreasing
renal excretion of acyclovir. Acyclovir may increase serum levels of
theophylline (Theo-Dur,
Respbid, Slo-Bid, Theo-24, Theolair, Uniphyl, Slo-Phyllin).
PREGNANCY: There are no adequate studies of acyclovir in
pregnant
women. In a patient registry of women who used acyclovir during the first
trimester, the rate of birth defects was similar to the rate of birth defects in
the general population.
NURSING MOTHERS: Acyclovir is excreted in
breast-milk, and a
significant amount may be transferred to the infant.
Shingles (herpes zoster) is a skin rash caused by the same virus that causes chickenpox. Under certain circumstances, such as emotional stress, immune deficiency, or with cancer, the virus re-activates causing shingles. Shingles are catching and can spread from an infected person to others who have not had chickenpox. There are a variety of treatments for shingles.
Herpes simplex infections are common and when they appear around the mouth and lips, people often refer to them as "cold sores" and "fever blisters." Canker sores are different than cold sores. Air droplets can spread the virus, as can direct contact with the fluid from the blisters. Cold sore treatment include over-the-counter medication as well as prescription medications.
Genital herpes, a viral infection by the herpes simplex virus (HSV), is transmitted during sexual contact with the mucous-covered linings of the mouth, vagina, or the genital skin. A typical outbreak begins with an itching or tingling sensation followed by redness of the skin and blister formation. The blisters and ulcers that form when the blisters break are painful to the touch, and last from 7 days to 2 weeks. Though there is no cure for herpes, there are ways to treat outbreaks.
Chickenpox (chicken pox) is a contagious childhood disease caused by the varicella-zoster virus. Symptoms have an incubation period of 14 to 16 days and include a couple days of mild fever, weakness, and red, raised rash that progresses to blisters that eventually burst and crust over. Complications include bacterial infection of the open sores, scarring, encephalitis, nerve palsies, and Reye's syndrome.
Pityriasis rosea is a rash that begins with a large pink patch with well-defined scaly borders on the back, chest, or neck. In one to two weeks, the person will develop many smaller pink patches on his or her trunk, arms, and legs. Symptoms include mild itching and possible sore throat, fatigue, nausea, aching, and decreased appetite. Pityriasis rosea typically resolves on its own and symptoms may be treated with topical steroid creams and oral antihistamines.
Ramsay Hunt syndrome is an infection of a facial nerve that causes a red painful rash with blisters and facial paralysis. The herpes zoster virus causes the infection. The infection is treated with antiviral agents, steroids, and pain medications.
Facial nerve disorders affect the muscles of the face. There are many causes of facial nerve disorders including: trauma, nervous system disease, infection, metabolic disorders, tumors, toxins, or Bell's palsy. Symptoms of facial nerve problems include: facial muscle paralysis, weakness, or twitching of the face; dryness of the eye or mouth, or taste alteration.
Becoming infected with chickenpox during pregnancy could cause birth defects in your unborn child. Likewise, shingles could also cause problems for your unborn child. If you are pregnant and haven't had chickenpox, avoid exposure to infected people. Zostavax, the shingles vaccine, can reduce the incidence of shingles by half. Women should wait at least three months after receiving the vaccine before trying to get pregnant.
Sexually transmitted diseases (STDs) are infections that can be
transferred from one person to another through any type of sexual contact. STDs
are sometimes referred to as sexually transmitted infections (STIs) since they
involve the transmission of a disease-causing microorganism from one person to
another during sexual activity. It is important to realize that sexual contact
includes more than just sexual intercourse (vaginal and anal). Sexual contact
includes kissing, oral-genital contact, and the use of sexual "toys," such as
vibrators. STDs probably have been around for thousands of years, but the most dangerous of these conditions, infection with the human immunodeficiency virus (HIV), was only recognized in recent decades.
Many STDs are treatable, but effective cures are lacking
for others, such as HIV, HPV, hepatitis B, and
hepatitis C. Even gonorrhea, once easily cured, has become resistan...
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