Exam 1 Treatment of select viral skin disorders

Question 1

Antiviral drugs have potential for ____ and so you should do a thorough medication history before prescribing

Answer 1

Antiviral drugs have potential for DDI and so you should do a thorough medication history before prescribing

Question 2

For many agents, dose adjustment needs to be made for ____/____ disease

Answer 2

For many agents, dose adjustment needs to be made for renal/hepatic disease

Question 3

Cause: mostly HSV 1

Answer 3

oral-facial herpes/herpes labialis

Question 4

Most patients have self-limiting (about ___ days) disease and drug treatment should be considered with respect to patient’s immune status and if prolonged disease is likely

Answer 4

10 days

oral-facial herpes/herpes labialis

Question 5

Treatment options are for IV (ONLY if systemic), buccal, PO, topical preparations

Answer 5

oral-facial herpes/herpes labialis

Question 6

For oral-facial herpes:

• Topical treatment ideally needs to start within an ____ or so of first symptoms/signs
• PO therapy needs to start within ___ ______

Answer 6

• Topical treatment ideally needs to start within an hour or so of first symptoms/signs
• PO therapy needs to start within 72 hours

Question 7

Topical options of oral-facial herpes

Answer 7

• Acyclovir (Zovirax) cream applied 5x/d x 4d
• Docosanol (Abreva OTC) cream applied 5x/d x 4d
• Penciclovir (Denavir) cream applied q2h while awake x 4d

Question 8

Oral options for oral-facial herpes(little/conflicting evidence to support use)

Answer 8

Can be good option for immune compromised or for suppression:
- Acyclovir (Zovirax) PO 3-5x/d x 5d

• Famciclovir (Famvir) single dose
• Valacyclovir (Valtrex) BID x 1d

Question 9

buccal options

Answer 9

Acyclovir (Sitavig) - $$$$$$$$

Apply one tablet to upper gum

Question 10

What type of vaccine is available for varicella/chickenpox?

Answer 10

childhood vaccine

Question 11

What can help with healing times and possibly prevent dissemination?

Answer 11

PO treatment

Question 12

PO treatment for varicella/chickenpox

Answer 12

Acyclovir: option for >12 yo, chronic cutaneous/pulmonary disorders, or those taking steroid/salicylate therapy

Question 13

What is herpes zoster/shingles?

Answer 13

reactivation of varicella virus

Question 14

What type of vaccine is available for herpes zoster/shingles?

Answer 14

adult vaccine in those 50-60+ yo with 1 dose

Question 15

PO treatment options for herpes zoster/shingles

Answer 15

• Acyclovir
• Famciclovir – benefit is fewer daily doses
• Valacyclovir – benefit is fewer daily doses

Question 16

Most commonly caused by HSV 2 but can get by HSV 1 if oral-genital contact is established

EASILY TRANSMITTED

Answer 16

genital herpes

Question 17

Treatment options include episodic, chronic suppressive, or no treatment

Answer 17

genital herpes

Question 18

Drug treatment/Prophylaxis for genital herpes

Answer 18

• Acyclovir
• Valacyclovir
• Famciclovir

Question 19

Tumor caused by human papillomavirus (HPV) infection of keratinocytes

Answer 19

warts

Question 20

procedure treatment options for warts

Answer 20

• cryotherapy
• instrumentation via cutting or curettage
• drugs

Question 21

drug treatment for warts

Answer 21

• Imiquimod (Aldara) – cream used for condyloma, perianal warts, actinic keratosis (AK) and basal cell carcinoma (BCC)
• Podofilox (Condylox) – topical gel or solution for genital warts

Question 22

What is MOA of imiquimod?

Answer 22

MOA unknown but thought to be immune modulation