Acyclovir and Idoxurodine

Acyclovir:

Deoxyguanosine analogue antiviral medication is acyclovir.

Mechanism of action:

• Thymidine kinase, an enzyme encoded by the herpes virus, transforms it into an active metabolite in the cell.

Indication:

• Genital herpes simplex.
• Herpes zoster.
• Herpes simplex keratitis.
• Herpes simplex encephalitis.
• Mucocutaneous herpes simplex.
• Chicken pox.

Dose:

• Adult:
  • Treatment of herpetic kerato-uveitis.
    • Child over 2 years and adult:
      • 400 mg 5 times per day for 7 days.
  • Treatment of genital herpes
    • Child over 2 years and adult:
      • 400 mg 3 times per day for 7 days; in immunocompromised patients, continue treatment until clinical resolution.
    • Secondary prophylaxis of herpes in patients with frequent and/or severe recurrences
    • Child over 2 years and adult:
      • 400 mg 2 times per day
  • Treatment of severe forms of zoster:
    • 800 mg 5 times per day for 7 days
• Child:
  • Herpes simplex:
    • Therapeutic dose:
      • Under two years: half the adult dose. But adult dose should be considered for above two years.
  • Varicella and Herpes zoster:
    • 12 years and over:
      • 20mg / k * g (max: 800 mg) qid for five days.
    • Above six years:
      • 800mg qid
    • 2-5 years:
      • 400mg qid
    • Under 2 years:
      • 200mg qid

Contraindication:

• Hypersensitivity

Side effects:

• Nausea, headache, agitation, coma, confusion, delirium, hallucination, aggressive behavior,psychosis, insomnia, ataxia, gastrointestinal distress, nausea, vomiting, diarrhoea, sweating, hypotension, alopecia, erythema multiforme.

Nursing consideration:

• With a full glass of water, acyclovir may be taken either with or without food.
• Patient should be well-hydrated if used systemically.
• If topically As soon as signs and symptoms appear, begin taking medication. When applying medication, use a finger cot or rubber glove.
• Before each usage, give the beverage a good shake to evenly distribute the medication.
• To avoid spreading the medication to other places and causing autoinoculation, use rubber gloves or finger cots when applying the medication.
• Complete the entire course as directed by your doctor, and don't go beyond the recommended dosage.
• Patients are advised from engaging in sexual activity while having noticeable lesions.
• Report any trouble urinating, rash, worsening, or increasing frequency of recurrences to your doctor.

Idoxuridine

Mechanism of action:

• Idoxuridine inhibits viral DNA polymerases and thymidilate phosphorylase, acting as an antiviral agent against DNA viruses. Idoxuridine's impact prevents the virus from replicating or infecting/destroying tissue.

Indication:

• Treatment of keratit is caused by the virus of herpes simplex.

Dose:

• Dosage Forms
  • Opthalmic drops 0.1%
  • Ophthalmic ointment 0.5%
  • Every hour, put one drop into the afflicted eye or eyes. When treating acute herpes, the dosage can be decreased from four times daily to every two hours before being stopped after seven days.

Contraindication:

• Hypersensitivity to idoxuridine, iodine or iodine-containing preparations, or any components in the formulation, lactation.

Side effects:

• Acute ocular irritation including burning, corneal stippling, vascularization, Increased sensitivity of eyes to light, itching, redness, swelling, pain, haziness of vision

Nursing Consideration:

Opthalmic drops 0.1%:

• Hands should be washed in warm water and soap before applying ophthalmic drops. Utilizing a fresh towel, dry them.
• You can do this by lying down or by looking in a mirror. Asking someone to verify that the drops enter the eye may be helpful.
• Use both eyes to scan the ceiling up above.
• Lean back and use one hand to pull your lower eyelid down. With the other hand, hold the bottle or tube. If necessary, keep it stable by resting a portion of your hand on your forehead.
• Put a drop or a small amount of cream inside your bottom lid. Avoid touching your eyes with the bottle or tube's tip.
• Blink, then use a tissue to wipe away any excess mucus.
• Use the drops first if you have both drops and ointment. If you don't, the eye drops might not be absorbed because of the ointment.
• If you have multiple types of drops, use the second one around five minutes after using the first.
• Eyes were closed for a while. This enables the medication to enter your eye.