Antiviral Medication for First and Recurrent Episode of Genital Herpes
Medication for first episode of Genital Herpes
The categories of antiviral medications against the first episode of Genital Herpes (caused by HSV-2) are many. It is understood that all other medications are nucleoside analogues except foscarnet and cidofovir. The major three medications namely acyclovir, famciclovir and valaciclovir are considered as effective medications against HSV – 2. Other antiviruses mentioned above, such as cidofovir, foscarnet, ganciclovir and valganiciclovir have also helped greatly in combating the first episodes of genital herpes. These are also useful against alpha herpes virus. They are used in special conditions such as treatment of some acyclovir – resistant HSV isolates.
It is a prototypic antiviral agent. It activates viral induced enzyme thymidine kinase in the initial stages of the first episode. The activity of acyclovir against VZV is ten times less than it’s activity against HSV. On the other hand, Epstein Barr Virus has minimal thymidine kinase activity because of it’s moderate susceptibility towards acyclovir.
Mechanism of Action:
Acyclovir is known to be a deoxyguanosine analogue. It has an acyclic side chain that lacks a 3 – hydroxyl group from the group of natural nucleotides. Since the missing group is required for the growth of DNA, the growth gets terminated. Hence, the viral DNA polymerase gets inactivated. This is where acyclovir comes into action. It is much more effective and a better substrate to for the viral polymerase instead of cellular DNA polymerase. The end result is the incorporation of acyclovir into cellular DNA.
Medication for recurrent episode of Genital Herpes:
An effective treatment for reoccurring episodes of Genital herpes is intravenous acyclovir therapy. The treatment is used when the patient encounters severe episodes of HSV or is hospitalized due to an escalated situation. A total of 5 – 10 mg/kg IV every eight hours for about 2-7 days is the recommended regiment. This may it may not be continued beyond 7 days which depends upon the clinical observation. Then follows an oral antiviral therapy which is to be undertaken for at least 10 days after the total therapy. HSV encephalitis is an intravenous therapy that requires a minimum of 21 days. Adjustment in the acyclovir dosage is confirmed with an impaired renal function.
Like every other medication that is synthesized, acyclovir has its own set of allergies and adverse reactions that are different in different individuals. They are not completely absent; the allergies and side effects are rare. Researchers have also found desensitization of acyclovir.
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