Shingles Lecture Flashcards
__________ (Varicella-zoster virus)
Painful, itchy, or tingly rash on one side of the body typically occurs during an infection with this common condition
Shingles
Symptoms of shingles
Rash around the left or right side of the body
______Itchy, or Tingly
Fever
Chills
Headache
Upset _______
painful
stomach
Causes and Spread of shingles
Caused by the varicella-zoster virus
People who never had chickenpox or didn’t get the chickenpox vaccine
Can become infected with ________
People with _________ are more likely to spread VZV than people with shingles
VZV
chickenpox
Prevention
RZV vaccine (Recombinant zoster vaccine):
Recommended in adults _______years and older
Helps protect adults 19 years and older who have ___________ systems
50 years
weakened immune systems
Shingles symptoms can occur several days before the rash actually appears but in the same area where the rash will occur. Some people also note that they experienced a fever before the rash develops as well there are people who describe fever,chills,headache,upset stomach and blisters of that rash then scab over in 7 to 10 days…there is a very serious and very common complication that could occur with shingles as well and that is long term pain known as ______________ or PHN and you can tell from that name that is specifically nerve pain
post-herpetic neuralgia
Shingles is herpes zoster…it’s a viral syndrome caused by reactivation of the ___________ virus so you can see here its caused by that virus…after an episode of varicella which is chickenpox the varicella zoster virus remains dormant or latent or quiet in the body but its still there and it lies in the nervous system of the body and herpes zoster typically occurs because its that reactivation of that virus later on in life older adults…elderly something that triggers it such as __________ will make it come out and reactivate and cause shingles…risk of shingles and serious complications increases as someone gets older if they have a medical condition that keeps their immune system from working from working properly or if they take medication or drugs that keeps their immune system from working properly all of those can put them at an increased risk…people who never had chicken pox or didn’t get the chickenpox vaccine can become infected but its interesting because if you are near someone with shingles you cannot get shingles from that person…but you can get chickenpox from someone who has shingles if you never had chickenpox or never got the chickenpox vaccine because of that you then have that virus inside of you and later on in life it could be the exact same thing where you then develop shingles…people who never had chickenpox or didn’t get the chickenpox vaccine like they said can get infected with the varicella zoster virus from someone who has shingles and these people can get the virus through either direct contact with the fluid from the shingles rash blisters or breathing in the virus particles that come from the blisters
varicella zoster
stress
risk of shingles and serious complications increases as someone gets older if they have a medical condition that keeps their ___________system from working from working properly or if they take medication or drugs that keeps their immune system from working properly all of those can put them at an increased risk…
immune system
people who never had chicken pox or didn’t get the chickenpox vaccine can become infected but its interesting because if you are near someone with shingles you cannot get shingles from that person…but you can get ________from someone who has shingles if you never had chickenpox or never got the chickenpox vaccine because of that you then have that virus inside of you and later on in life it could be the exact same thing where you then develop shingles…
chickenpox
people who never had chickenpox or didn’t get the chickenpox vaccine like they said can get infected with the ___________ virus from someone who has shingles and these people can get the virus through either direct contact with the ________ from the shingles rash blisters or ________ in the virus particles that come from the blisters
varicella zoster
fluid
breathing
Prevention
Other measures:
__________ the shingles rash
Avoid touching or ____________ the rash
_______ hands often
Avoid contact with those at higher risk
Cover
scratching
Wash
Shingrix
Schedule: 2-dose series
1st dose separated by ____ to ______
months from 2nd dose
Reminder tools
Side effects
Efficacy: > 90% effective
2 to 6 months
Treatment
______________medicines: work to shorten the length and severity
Acyclovir
Valacyclovir
Famciclovir
Pain relief medicines
_____ compresses
_______ lotion
Warm oatmeal baths
Antiviral
Wet
calamine
CDC recommends ______doses of the recombinant zoster vaccine (RZV) also called Shingrix to prevent shingles and the related complications in adults 50 years and older.
Furthermore, CDC recommends that adults ages 19 years and older who have weakened immune systems because of disease or therapy are also able to get the shringrix vaccine. On top of direct vaccine prevention there are other measures that can help to lower the risk of spreading the shingles virus to others and while people with shingles can not spread the virus before the blisters appear or after the rash scabs over we can still tell them that throughout the entire time they have their rash they should be covering it they also should be avoid touching or scratching the rash
2 doses
There are treatment options that can help lessen the itch and therefore make it less necessary for someone to feel like they have to scratch their rash also the importance of washing their hands in order to decrease the spread and washing hands often for at least 20 seconds each time…furthermore avoiding contact with certain people when your rash before it has scabbed over so making sure that we educate our patients not only those that have shingles but also those that might be going to visit,spend time or care for someone who does have the shingles rash so those specific patient populations that we want to educate to avoid contact with are our pregnant individuals especially our ________ individuals who have never had chickenpox or the chickenpox vaccine also ________ or low birth weight infants and also people with ___________ immune systems all of which should be educated to decrease that time spent and avoid contact especially before rash has scabbed over now we discussed that the shingrix vaccine should be given to our adults 50 years and older but I also want to point out that we can educate our pts that even if you know if you had shingles in the past you should still be vaccinated with Shingrix because that virus is laying dormant in the body and its not something that’s a one and done it could reactive again and so even if someone has had that…shingles rash in the past they should still get the Shingrix vaccine now before Shingrix was out we had a vaccine called Zostavax even if someone was vaccinated with Zostavax years ago they should also still receive their 2 dose series of Shingrix even if a person has received the varicella or chickenpox vaccine they should also be vaccinated with Shingrix
pregnant
premature
weakened immune systems
CDC recommends shringix for adults 50 years and older but there is no maximum age for getting Shingrix so no matter when someone is able and willing to come in as long as they are over the age of 50 they can and should receive their 2 dose series
Chickenpox and shingles are related because they are caused by that same varicella zoster virus and once again just to reiterate after a person recovers from chickenpox the virus stays dormant or inactive in the body and it can reactive years later and cause shingles so when somebody has had shingles as long as there shingles rash is cleared they can receive their dose of Shingrix
Whether or not they remember having chickenpox they should still get shringrix its has been noted that more than 99% of americans born on or before 1980 have had chickenpox even if they don’t remember having it and that’s why the CDC recommends blanket statement anybody 50 and older should be getting the shringrix vaccine
2 vial specifically named zoster vaccine recombinant adjuvanted with the brand name shringrix now in those 2 vials you have 1 vial that’s the antigen which is to be ______________ with 1 vial of the adjuvant suspension so an _________ is an added component which is used to enhance the body’s immune response to the vaccine making it so that we can see numbers of greater than 90% efficacy now with that 90% efficacy and with that added component of adjuvant we also see very common and also one intense side effect and that is the muscle pain,redness and swelling of the injection site so that is very common and very painful…so tell pt about this ahead of time because when they get home they might feel the worst pain at the injection site
reconstituted
adjuvant
These are side effects are fleeting and they will go away and they are NOT shingles and they are there reminding us that we received a vaccine that will help greater than 90% efficacy to keep us from getting shingles in the future
Prior to reconstitution both antigen and adjuvant vials should be stored at 36 degrees to 46 degrees Fahrenheit,protect from light, should not be frozen, should be refrigerated, should always be discarded if they were ever frozen. After reconstitution the vaccine should be administered immediately or it can be stored at refrigerated temperatures so again 36 degrees Fahrenheit to 46 degrees Fahrenheit and given within 6 hours…if that vaccine was not given after reconstitution within 6 hours it should be discarded
NEVER FREEZE AND DISCARD IF IT WAS FROZEN
A virus lays dormant and staying within the body.
Antiviral medication won’t cure it
Acyclovir, valacyclovir, and famiciclovir can be _____________ by a provider and they do work best when taken as soon as the rash appears
Pain relief medicines can be prescribed by a provider or it can be taken over the counter
prescribed
