Oral Infections (viral)

Question 1

What is the management of primary herpetic gingivostomatitis? (4)

Answer 1

1. Soft diet
2. Adequate fluid intake
3. Analgesics as required (local benzydamine hydrochloride)
4. Chlorhexidine mouthwash if tooth brushing is painful (also helps control secondary infection)
5. Systemic antiviral (if severe infection) ie aciclovir

**valaciclovir or famciclovir are suitable alternatives to aciclovir for oral lesions associated with herpes zoster

Question 2

What is the treatment of choice for frequently recurring herpes simplex lesions of the mouth?

Answer 2

Aciclovir or valaciclovir

Question 3

What precautions should be taken when prescribing valaciclovir and aciclovir? (2)

Answer 3

1. Additional monitoring in elderly patients for neurological reactions
2. Adequate hydration (especially at high doses) to avoid toxicity

Question 4

What is valaciclovir?

Answer 4

A pro-drug of aciclovir

Question 5

Is aciclovir safe to use in pregnancy and breastfeeding?

Answer 5

Yes

Question 6

What neurological side effects should you be on the look out for when treating patients with aciclovir?

Answer 6

Especially in elderly patients and those with impaired renal function…

Agitation 
Ataxia
Confusion 
Coma 
Dizziness
Dysarthria 
Encephalopathy
Hallucinations 
Psychosis 
Seizure
Tremor

Question 7

What flavors are available for oral liquid preparations of aciclovir?

Answer 7

Banana
Orange
Unicorn tears
:)