22 Jun What drug therapy would you prescribe?
What drug therapy would you prescribe? Why?
The position regarding the patient J.R, shows she is exhibiting symptoms of adenopathy with signs of vaginal and cervical lesions that may be herpes simplex virus (HSV-2). The priority for the patient is to intervene and reduce the amount of the pain and alleviation of the swelling due to the adenopathy. The initial drug for therapy to reduce the discomfort would be Ibuprofen. The treatment helps manage adenopathy by reducing the swelling and assisting in defeating the pain (Afzal, 2020). With Ibuprofen, pain receptors are suppressed, and successful processes are applied to overcome obstacles and the infections while improving the quality of health (Afzal, 2020).
The second medication suggested for J.R is treatment for the HSV infections in the form of antivirals like Acyclovir (Zovirax), valacyclovir (Valtrex), and famciclovir (Famvir). Daily antiviral therapy with famciclovir and valacyclovir has been shown to be successful in lessening both symptomatic and asymptomatic reactivation of herpes simplex virus (Wald et al., 2006). The three antivirals are the most common however, Valacyclovir appear to be somewhat better than the others for suppression of genital herpes and associated shedding (Wald et al., 2006). Treatment for the first clinical event of genital herpes consist of antiviral therapy and counseling about the natural history of the virus, sexual and perinatal transmission, and methods to reduce transmission. Antiviral therapy for the initial outbreak with Valacyclovir is 1 gram two times a day for 7 to 10 days (Arcangelo et al., 2017).
What are the parameters for monitoring the success of the therapy?
The first parameter is a lessening in the painful episodes as an indication of initial successful therapy. A prominent reduction in adenopathy symptoms such as swelling is an indicator of effective treatment (Afzal, 2020). The occurrence of ulcers and vaginal sores are a considerable nuisance to the patient, and a successful drug therapy involves a factor of the recovery from the condition. Furthermore, completing a thorough physical examination to examine if the symptoms existing prior to therapy have improved is vital. Lastly, regular bloodwork and diagnostic testing should be evaluated to understand if the medication and treatment is working (Arcangelo et al., 2017).
Discuss specific education for J.R. based on the diagnosis and prescribed therapy.
For patients with the HSV-2 infection manifested as genital herpes, instruction to the patient regarding sexual activity, recurrence, and the unstable course of the disease is essential (Arcangelo et al., 2017). In addition, due to the presence of vaginal and cervical lesions, the patient must practice avoiding sexual intercourse for one month to give enough time for healing (Peña & Sklar, 2019). Sexual intercourse results in bruising and may result in adverse sores and more painful episodes hence acting as a barrier to quality and successful healing. Complying with drug dosage and medications is another health education teaching to assist the patient overcome some of the symptoms of HSV (Peña & Sklar, 2019). The reporting of any drug reaction or abnormal amounts of breakouts should be addressed with the patient to assist in being proactive towards the treatment.
References
Afzal, O. (2020). Genital Ulcer Disease. Obstetrics and Gynecology, 253-257. https://onlinelibrary.wiley.com/doi/abs/10.1002/9781119450047.ch31
Arcangelo, V. P., Peterson, A. M., Wilbur, V. F., & Reinhold, J. A. (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Lippincott Williams & Wilkins
Peña, A., & Sklar, D. P. (2019). Moving our education priorities from sickness to health: The opportunity for health promotion, disease prevention, and population health to transform health professions education. Academic Medicine, 94(6), 741-743.
Wald, A., Selke, S., Warren, T., Aoki, F. Y., Sacks, S., Diaz-Mitoma, F., & Corey, L. (2006). Comparative efficacy of famciclovir and valacyclovir for suppression of recurrent genital herpes and viral shedding. Sexually transmitted diseases, 33(9), 529–533. https://doi.org/10.1097/01.olq.0000204723.15765.9
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