Viral Infections

Question 1

Primary managment of herpes simplex infection (primary herpetic gingivostomatitis)

Answer 1

Primary herpetic gingivostomatitis [as a result of herpes simplex virus (HSV)] is best managed by symptomatic relief [i.e. nutritious diet, plenty of fluids, bed rest, use of analgesics and antimicrobial mouthwashes (either chlorhexidine or hydrogen peroxide )]. The use of antimicrobial mouthwashes controls plaque accumulation if toothbrushing is painful and also helps to control secondary infection in general.

Question 2

Primary Managment of herpes simplex, mouthwashes ?

Answer 2

Chlorhexidine Mouthwash, 0.2%
Send: 300 ml
Label: Rinse mouth for 1 minute with 10 ml twice daily

Hydrogen Peroxide Mouthwash, 6%
Send: 300 ml
Label: Rinse mouth for 2 minutes with
15 ml diluted in half a tumbler of warm water three times daily
Chlorhexidine gluconate might be incompatible with some ingredients in toothpaste; advise patient to
leave an interval of at least 30 minutes between using mouthwash and toothpaste. Also advise patient that
chlorhexidine mouthwash can be diluted 1:1 with water with no loss in efficacy.

Question 3

Managment of herpes simplex in infections in immunocompromised patients and severe infections in nonimmunocompromised patients.

Answer 3

Aciclovir Tablets, 200 mg
Send: 25 tablets
Label: 1 tablet five times daily

Aciclovir Cream, 5%
Send: 2 g
Label: Apply to lesion every 4 hours (five times daily) for 5 days

Penciclovir Cream, 1%
Send: 2 g
Label: Apply to lesions every 2 hours during waking for 4 days

Question 4

Managment of herpes zoster (shingles)

Answer 4

Aciclovir Tablets, 800 mg (shingles treatment pack)
Send: 35 tablets
Label: 1 tablet five times daily

Systemic antiviral agents reduce pain, and reduce the
incidence of post-herpetic neuralgia and viral shedding