Acyclovir in angina: effective treatment of herpetic infection

Mucous membranes of the tonsils can be affected, either by bacteria or fungi, or by viruses. And in all cases, the disease will be called the same - angina, or tonsillitis - and treatment will be assigned differently. For example, Acyclovir in angina is prescribed only for viral damage: if the inflammatory process was provoked by bacteria or fungi, then this drug will be simply useless.

Viral angina is a disease that is no less common than bacterial angina. It is capable of causing influenza viruses, as well as the ECHO virus and Coxsackie.

Does Acyclovir help in tonsillitis?

At the first signs of angina, it is necessary to determine the origin of the disease as soon as possible: it is caused by a virus or bacteria. From this, in the first place, depends on the intended treatment. Since Acyclovir is an antiviral drug, with bacterial tonsillitis its use is inexpedient, and vice versa - antibiotics for herpes sore throat will not help.

Most often the doctor does not spend time on carrying out a diagnostic smear for bapsoseva: waiting for its results will last a long time, and treatment should be performed immediately (although conducting such a diagnosis is the best option for optimal therapy effectiveness). Most doctors act according to two principles. The first principle is the simultaneous administration of both an antibiotic and Acyclovir (or another antiviral drug). This approach is not entirely correct, since it gives the patient an additional and strong medical burden. The second principle is a careful analysis of the symptoms: the doctor tries to understand by the nature of the clinical picture of what angina is involved - about the viral or bacterial. So, if the patient has symptoms such as fever, enlarged tonsils and lymph nodes, pain in the head and throat, but the patient does not complain of a cough or runny nose - he most likely has a viral sore throat. An additional sign is the appearance of a red rash and sores on the tonsils.

With bacterial sore throat, the temperature is present, but insignificant, rhinitis, cough, and voice changes. Also, with microbial disease, in many cases there is a white coating on the glands, and the lymph nodes do not increase.

Such an approach to determine the etiology of the disease may occur, but there are also cases of atypical disease: in this situation, the causative agent's causality is difficult to guess.

In view of the foregoing, it can only be confirmed that the only accurate method for determining the viral or bacterial origin of angina is laboratory diagnosis and bacussis.

[1], [2]

Indications Acyclovir in angina

Acyclovir in case of angina of viral origin promotes an early cure of the disease, reduces the likelihood of the spread of the inflammatory process and the development of complications from the internal organs, reduces the pain of the throat in the acute stage of tonsillitis.

Acyclovir in herpes angina also exhibits an immunostimulatory effect (aimed at stimulating the body's protective response to the introduction of the virus).

In addition to viral sore throat, Acyclovir can be used in other herpes simplex viruses, with shingles, as well as to prevent viral diseases in patients with impaired immunity.

[3], [4], [5]

Acyclovir in purulent angina

We have already said that angina can be viral, or microbial. Speaking of purulent angina, they usually have in mind exactly the disease of microbial origin, which is most often caused by streptococcus pyogenes, somewhat less often - by staphylococcus, hemophilic rod or Neusheria. The listed microorganisms are exclusively bacterial flora on which Atsiklovir does not render the slightest influence. Treatment of purulent sore throat should be done only with antibacterial medicines: therapy is prescribed by the course, after a preliminary analysis to identify the pathogen and determine its sensitivity to antibiotics.

[6]

Release form

Today, on the shelves of drugstores, there are several different forms of drug release Acyclovir. These are tablets, ophthalmic ointment, ointment for external use and lyophilizate for making a solution with subsequent intravenous administration:

• Tablets of white color contain 0.2 g of active acyclovir in one piece.
• Ointment Acyclovir 5% for external use, 5 or 10 g in an aluminum tube. Acyclovir ointment for the throat is used, lubricating the affected tonsils for 5-10 days.
• Powder-lyophilizate Acyclovir for the manufacture of infusion solution (bottles of 250 mg, 500 mg and 1000 mg).

Before proceeding with the selection of a specific form of the drug, you need to assess the patient's condition. For example, if treatment of sore throat is performed on an outpatient basis, it is permitted to use tablets and ointment.

If the disease is severe and has a high risk of complications, then the treatment is carried out permanently, using injections of the drug.

The drug is manufactured by many pharmaceutical companies, so it can have double names that match the manufacturer's brand. So, the most famous are: Acyclovir acrikhin, Darnitsa, Stada, Astrafarm, Farmak, Vishfa, Belupo, ZhFF, Belmed, etc.

[7], [8]

Pharmacodynamics

Acyclovir is a synthetic analogous substance of purine nucleoside and has inhibitory activity in vivo / in vitro with respect to human herpetic viruses. This is a herpes simplex virus of the first and second type, the virus of chickenpox and herpes zoster, cytomegalovirus and the Epstein-Barr virus. Acyclovir has a highly selective inhibitory activity against the above-mentioned infectious agents. The enzyme substance thymidine kinase in a healthy uninfected cell does not consider acyclovir in the form of a substrate, therefore the toxic effect on body cells is always minimal. Nevertheless, thymidine kinase, which is encoded in viral cells, transforms acyclovir into acyclovir monophosphate. This substance is an analogue of a nucleoside, which is subsequently converted step by step into diphosphate, and then into triphosphate. The latter interacts with viral DNA polymerase, immediately after the introduction of acyclovir into viral DNA. As a result of these processes, the synthesis of the viral DNA chain is blocked.

[9], [10]

Pharmacokinetics

Absorption of Acyclovir in the intestinal cavity is only partial.

In adult patients, the final half-life with intravascular administration of the drug may be 2.9 hours. Most of the injected Acyclovir leaves the body unchanged through the kidneys. The parameters of renal clearance significantly exceed the values of creatinine clearance: this indicates that the drug is excreted by the kidneys not only through glomerular filtration, but also due to tubular secretion.

A significant metabolite of acyclovir is 9-carboxymethoxymethylguanine, whose share is 10-15% of the total amount of the drug found in the urinary fluid. If Acyclovir is taken 60 minutes after the use of one gram of probenecid, the final half-life and the area under the concentration / time curve increase by 18% and 40%, respectively.

If the patient suffers from a chronic failure of the kidney function, the average half-life can be 19½ hours. The average half-life of the drug during hemodialysis is 5.7 hours. The content of Acyclovir in the blood serum during hemodialysis is reduced by 60%.

The content of medicament in the cerebrospinal fluid can be about 50% of the corresponding content in the blood serum. The degree of binding to plasma albumins is relatively small (9-33%).

[11], [12]

Dosing and administration

Acyclovir in tableted form is taken for the treatment of viral angina immediately after eating, washed down with water. Dosing is coordinated by the treating doctor. Typically, this therapy is used: adult patients take 200-400 mg of the drug every four hours, five times a day (at night the drug is not taken). Duration of treatment - 7 days.

Patients with impaired renal function need to adjust the dose and regimen by monitoring the amount of creatinine clearance, and considering the type of viral damage. If the pathogen is Herpes simplex, and the creatinine clearance is less than 10 ml / minute, then the daily amount of the drug should be reduced to 400 mg (in two divided doses at 12 hours intervals).

Acyclovir ointment for the throat is used up to 6 times a day, at the same time intervals, lubricating the affected tonsils. It is very important to begin treatment of tonsils at the earliest stages of the appearance of tonsillitis. The treatment is continued until the healing of the vesicles (from five to ten days) occurs.

[17]

Acyclovir in case of angina in children

An angina of viral origin in young children can cause the development of such a dangerous condition as a false cereal. The condition is accompanied by swelling of the larynx, narrowing of its lumen, suffocation. To prevent complications, it is recommended to start treatment as early as possible - in particular, to use Acyclovir.

Children under one year of age are treated with antiviral treatment using rectal suppositories (suitable candles such as Viferon or Genferon light).

Treatment of the throat can be practiced from the age of 4 years.

Tablets Atsiklovir with angina paediatrics appoint in such dosages:

• a child from 1 to 2 years old - 100 mg (half a tablet) for five days every 4 hours;
• a child from 2 to 5 years - 200 mg 4 times a day;
• a child older than six years - 200-400 mg 4 times a day.

The duration of treatment is determined by the doctor, assessing the dynamics of recovery of the baby.

[18],

Use Acyclovir in angina during pregnancy

Until now, there was no any adverse effect of Acyclovir on the course of pregnancy and on the development of a future baby. But doctors still advise to take care of the drug cautiously and take it only in case of emergency, and only under the supervision of a doctor.

Acyclovir in case of angina is prescribed for future mothers in case the possible harm from the drug is minimal in comparison with the danger posed by a viral infection.

According to pharmacists, after ingestion of 200 mg of Acyclovir five times a day, the active ingredient of the medication enters the breast milk. Its concentration ranges from 0.6 to 4.1%, based on the corresponding content of the drug in the blood serum.

It is believed that the infant is able to assimilate the drug in an amount of not more than 0.3 mg per kg of body weight per day. Therefore, before assigning Acyclovir in the angina of a nursing mother, it is necessary to carefully evaluate the likely risks and benefits.

Contraindications

It should not be treated with Acyclovir in case of angina, if the patient has a high sensitivity to such antiviral drugs, including such as Valaciclovir, Hankclioir, etc.

It is extremely undesirable to take Acyclovir at the breastfeeding stage, and also in childhood up to 3 years.

Special care should be taken if the drug is to be taken during pregnancy, in old age, as well as when the patient is dehydrated, or suffers from kidney failure, neurological disorders, or exhibits a neurological response to cytotoxic medication.

With angina of bacterial origin, Acyclovir is unreasonable and unreasonable.

[13], [14], [15]

Side effects Acyclovir in angina

The appearance of side effects is not a frequent phenomenon in the treatment of angina by Acyclovir. However, sometimes they can occur as one or more of the following:

• anemia, leukopenia, thrombocytopenia;
• allergic reaction;
• pain in the head, dizziness, irritability, trembling in the hands, cramps, drowsiness;
• dyspnea;
• nausea, vomiting, diarrhea, abdominal pain;
• jaundice;
• itching, rashes, photosensitivity;
• low back pain;
• increased fatigue.

These symptoms are transient and completely disappear after the end of Acyclovir treatment. In addition, their occurrence is more often associated with the presence of a patient with renal insufficiency or other background diseases.

[16]

Overdose

Antiviral medication Acyclovir is not fully absorbed in the digestive system. There are cases when patients after accidental intake of up to 20 g of the drug did not show any toxic effect. But after a repeated accidental episode of an overdose for several days, the following symptoms were noted in patients:

• from the side of the digestive tract - nausea with vomiting;
• from the side of the central nervous system - pain in the head, impaired consciousness.

With intravascular overdosage, the creatinine content in plasma, urea nitrogen increases: renal function deficiency develops. From the side of the nervous system, there are violations of consciousness, excitement, convulsions, coma.

Treatment is carried out in a hospital, after assessing the severity of intoxication. Recommended as early as possible to wash the stomach, apply symptomatic drugs. Acyclovir is well amenable to elimination, so hemodialysis can and should be used with a confirmed overdose.

[19], [20], [21]

Interactions with other drugs

Acyclovir in angina can be taken without fear: clinically important interactions with other medications have not been found.

The active ingredient is excreted mostly unchanged through the kidneys, so it is possible that any medications with the same excretion principle can affect the concentration of acyclovir in the serum.

In combination with immunosuppressive drugs, the content of acyclovir in serum can also increase. However, adjustments in the dosage and treatment regimen of angina with Acyclovir are not required.

Storage conditions

Acyclovir is allowed to be stored in ordinary room conditions with an average temperature of about + 25 ° C, away from solar radiation and heating devices. Storage space should not be accessible to children.

[22], [23]

Shelf life

Store the sealed intact drug Acyclovir for three years, counting from the production date.

[24],

Analogues

Complete analogs of Acyclovir, which can also be used to treat viral sore throat, are:

• Provirsan;
• Medov;
• Herpetad;
• Zovirax;
• Gerpevir;
• Gaviran;
• Acivir;
• Biocyclovir;
• Atsigerpin;
• Virolex;
• Acik.

[25], [26], [27], [28]

Derinat with herpetic sore throat

Against the background of treatment with angina Atsiklovirom you can use other auxiliary medications - for example, Derinat. This drug is based on the action of sodium deoxyribonucleate and is an effective immunomodulator that stimulates the response of cellular and humoral immunity. It enhances the effectiveness of Acyclovir, activating the immune response to the introduction of a viral infection.

With angina, Derinat is used in the form of nasal drops, 2-3 drops each, or 2 sprays each nostril once every 1-1.5 hours during the first day. Then the frequency is reduced to 3-4 times a day. Duration of treatment - up to one month.

The drug can be used at any age, beginning with the period of the newborn.

Lugol with herpes sore throat

Lugol solution - an antiseptic solution based on iodine and potassium iodide, is used for the treatment of tonsils with angiomas of bacterial origin. Herpes sore throat is not a direct indication for the use of the drug, so combining the solution with Acyclovir is not always advisable. However, this drug can be used to prevent the development of secondary infections and complications of bacterial etiology.

Lugol's solution has a bactericidal property, destroying gram-positive and gram-negative microbes (streptococcus, staphylococcus, E. Coli, vulgar proteus, klebsiel). The virus does not affect the virus infection.

Reviews

The vast majority of reviews indicate good efficacy of Acyclovir in case of angina caused by the action of the virus. The main point is the timely start of treatment at the first signs of the inflammatory process. This approach will avoid complications, quickly reduce the manifestation of unpleasant symptoms, reduce the overall period of the disease.

Many doctors advise against taking Atsiklovira in addition to take other drugs to implement a comprehensive impact on the problem:

• non-steroidal anti-inflammatory drugs that will speed up the coping of the inflammatory process and relieve the painful sensations (Ibuprofen, Nimesil);
• mucolytic agents for the elimination of irritation of mucous tissues;
• antihistamines for swelling in the throat.

During the entire period of therapy you need to adhere to bed rest, drink warm, vitaminized drinks - for example, tea with lemon, rose hip infusion. Warm up the throat compresses should not: in a viral disease, this can only worsen the situation.

If you work on the problem comprehensively, you will be able to forget about the disease soon. The above additional drugs will help to smooth out the underlying manifestations of the disease, and Acyclovir in angina can destroy the virus itself.