Jamie Rubinstein

Acyclovir

Acyclovir
Acyclovir is an antiviral drug that was initially discovered by James W. Black in 1972 (Physiology, 1988). The medication reduces and slows the spread as well as expansion of the herpes virus, including genital herpes, shingles, cold sores, and chickenpox (Acyclovir, 2011). Acyclovir is most commonly used to treat genital herpes simplex, which is a sexually transmitted disease affecting millions of people worldwide (Genital Herpes, 2011). There is no permanent cure for this virus; Acyclovir is one of the leading medications to help lessen symptoms while preventing growth of genital herpes simplex (Albrecht, 2011).

History
Acyclovir was the first established anti-viral drug used to treat the sexually transmitted disease genital herpes. A screening program was developed in the 1960’s in order to test specific antiviral drugs, setting the stage for the eventual establishment of Acyclovir (American, 1988). With the underlying research performed by James W. Black, Acyclovir was then discovered in 1972 (Physiology, 1988). The drug was believed to be a successful antiviral created to treat infections caused by herpes (Acyclovir, 2011). Gertrude Elion and George Hitchings joined the research team in 1977 bringing clinical trials in order to further investigate the actual effectiveness of Acyclovir (Physiology, 1988). With the increasing amounts of Herpes simplex outbreaks correlating with the amount of premarital and non-protective sex taking place in the late 1970’s, the need for a usable herpes medication was imperative. Finally in 1982, the first form of Acyclovir was out on the market in topical for topical use (American, 1988). In 1988 Sir James W. Black, Gertrude B. Elion and George H. Hitchings were awarded the Nobel Peace Prize in Physiology or Medicine for their discoveries in “important principles for drug treatment” (Physiology, 1988). Acyclovir eventually was available in multiple forms and can be taken as an oral pill, an injection, or applied as a topical cream.

Purposes
Acyclovir can be prescribed to treat those who have various kinds of herpes infections. According to the National Center of Biotechnology Information, Acyclovir is used to decrease pain and speed the healing of sores or blisters in people who have chickenpox, shingles, cold sores, and sexually transmitted genital herpes (Acyclovir, 2011). Although Acyclovir can be used to treat any of these strains of herpes virus, doctors generally turn to the drug to help treat individuals with both initial and reoccurring outbreaks of sexually transmitted, genital herpes simplex (Albrecht, 2011).

Genital Herpes Simplex (HSV)
Acyclovir is primarily used to treat genital herpes simplex (Albrecht, 2011). “Genital herpes is a viral infection that can be spread through sexual contact” (Genital Herpes, 2011). Genital herpes is classified as being a sexually transmitted disease. According to the American Congress of Obstetricians and Gynecologists, genital herpes “affects one in five adults in the United States- about 45 million people” (Genital Herpes, 2011).
Most people who become infected with genital herpes are not aware that they carry the disease until their first outbreak. Even after the initial outbreak, the virus stays in the body even when physical outbreaks are not present. Most outbreaks occur two weeks after the virus is transmitted (Genital Herpes, 2010). Outbreaks consist of a possible fever as well as clusters of sores and blisters that can typically appear around the lips, genitals, or anus healing in two to four weeks (Genital Herpes, 2011). Genital herpes is a virus that infects healthy cells; once the immune system begins to try and fight back, the sores and blisters begin to appear. Besides the sex organs, “genital herpes can affect the tongue, mouth, eyes, gums, lips, fingers, and other parts of the body” (Genital Herpes, 2011).

In addition to causing painful sores and blisters, genital herpes can cause severe psychological distress in those that carry the disease creating a more stressful sex life (Genital Herpes, 2010). Genital herpes simplex has shown to be fatally dangerous to newborn babies. Along with preventing the contraction of the virus, a pregnant mother who already carries genital herpes generally receives a cesarean surgery in order to protect the newborn baby (Genital Herpes 2010). A physician can easily diagnose herpes with minimal tests including sample swabs as well as blood tests (Genital Herpes, 2011).

Treatment for Herpes
The first medical suggestion to avoid contracting genital herpes is to abstain from sex or use barrier protection in the form of a condom every time when having sex. There is no final systemic cure for genital herpes (Genital Herpes, 2011). Despite this disheartening news for patients, there are medications that can shorten the duration of outbreaks while assisting in decreasing the discomfort brought with the sores and blisters (Genital Herpes, 2010). According to the Center for Disease Control and Prevention, “antiviral medications can shorten and prevent outbreaks during the period of time the person takes the medication” (Genital Herpes, 2010). Antiviral medications can be distributed on an initial, an intermittent, or a suppressive level (Treatment, 2010). If an individual experiences repeating episodes of outbreaks suppressive treatment with daily medication becomes the best bet for reducing symptoms (Genital Herpes, 2011). Antiviral medications used for treating Genital Herpes simplex include, Famciclovir, Valacyclovir, and Acyclovir (Albrecht, 2011).

Symptomatic Treatment for Herpes with Acyclovir
Antiviral medications, such as Acyclovir, work to attack the genital herpes virus therefore reducing symptoms and preventing future outbreaks. Acyclovir is distributed as an injection, a topical cream, as well as an oral pill. Generally doctors choose the pill, stay away from the topical cream, and refer to injection in special cases (Albrecht, 2011).
There are three levels of symptomatic treatment when using an antiviral such as Acyclovir: Initial, intermittent, and suppressive (Treatment, 2010). Initial treatment is generally applied when an individual is first diagnosed with the virus and Acyclovir will be prescribed for seven to ten days in hopes of reducing pain from the sores or preventing a heightened outbreak (Albrecht, 2011). Depending on the specific patient, intermittent treatment might be the next course of treatment plan. Intermittent treatment includes having prescribed Acyclovir available to the individual incase of an outbreak (Treatment, 2010).
If outbreaks persist repeatedly, a doctor may suggest to the individual to partake in suppressive treatment with Acyclovir (Treatment, 2010). This type of treatment includes taking Acyclovir orally every day. Suppressive treatment is often recommended for patients who have multiple, non-consistent sexual partners. Many studies have proven that acyclovir, if used correctly, can significantly decrease healing time and the duration of viral shredding while reducing pain. Each treatment plan using Acyclovir should be adapted specifically for the individual so the drug can be most effective (Albrecht, 2011).

Prophylactic Treatment for Herpes with Acyclovir
Prophylactic treatment is also known as preventative treatment, in order to reduce the likelihood of a relapse. In the case of prophylactic treatment for genital herpes simplex, Acyclovir is generally used to prevent the virus from creating another outbreak and more often used in order to protect another (Albrecht, 2011). Prophylactic treatment for genital herpes comes in the form of suppressive treatment so that the oral medication is administered every day (Treatment, 2010). Antiviral medications such as Acyclovir weaken the viral infection within an individual, stopping it from spreading it further, therefore reducing the chances significantly of the carrier passing it on to a partner or newborn (Albrecht, 2011). Individuals interested in a prophylactic treatment plan usually include someone who is a carrier, but who’s monogamous sexual partner is not. Another type of common candidate for suppressive, preventative treatment is an infected pregnant woman (Treatment, 2010). In case a cesarean surgery is not an option at delivery time, the carrier mother will start taking Acyclovir every day during the last month of her pregnancy in order to protect the potentially exposed newborn, where the virus can be deadly (Albrecht, 2011).


Side Effects
Acyclovir can cause multiple symptoms such as: dizziness, headaches, nausea, vomiting, diarrhea, joint pain, and hair loss (Acyclovir,2011). If experiencing any of these symptoms a doctor should be contacted in order to review the individual’s treatment plan. It is imperative to call a doctor immediately if there is a suspected overdose, signs of a rash, or severe forms of the expected side effects (Acyclovir, 2011).


References

Albreact, M. A. (2011). Treatment of genital herpes simplex infection. In B. Rose (Ed.), Up to Date. Available from www.uptodateonline.com.

Acyclovir. (2010). Drugs.com. Retrieved April 10, 2011, from http://www.drugs.com/acyclovir.html

Acyclovir. (2011). Everyday Health, Retrieved April 10, 2011, from http://www.everydayhealth.com/drugs/acyclovir

Acyclovir. (2011). Pubmed health. Retrieved April 10, 2011, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000533/

American Academy of Dermatology, Initials. (1988). History, pharmacokinetics, and pharmacology of acyclovir. . Journal of the American Academy of Dermatology, Retrieved April 10, 2011, from http://www.ncbi.nlm.nih.gov/pubmed/2828440

Genital herpes. (2010). Center for Disease Control and Prevention, Retrieved April 10, 2011, from http://www.cdc.gov/std/Herpes/STDFact-Herpes.html

Genital herpes. (2011). The American Congress of Obstetricians and Gynecologists , Retrieved April 10, 2011, from http://www.acog.org/publications/patient_education/bp054.cfm

Physiology of medicine 1988-press release. (1988). Nobelprize.org, Retrieved from April 10, 2011, http://nobelprize.org/nobel_prizes/medicine/laureates/1988/press.html

Treatment options for genital herpes. (2010). WebMD, Retrieved April 10, 2011, from http://www.webmd.com/genital-herpes/guide/genital-herpes-treatment-options
image_1.jpg


image_2.jpg