Shingles has another name - shingles. The causative agent of this infectious pathology is the herpes virus. The disease affects the skin and nervous system, and therefore therapy is carried out by both dermatologists and neurologists, depending on which clinical symptoms are most pronounced. Herpes zoster and chickenpox share a common etiology and pathogenesis. This is a secondary infection of endogenous origin in people who have previously had chickenpox in a latent or clinical form. After chickenpox, viruses can persist in the body for a long time. They are localized in the ganglia of the cranial nerves and spinal ganglia, and under the influence of pathogenic factors they are reactivated, which is most often observed when cellular immunity is weakened.
Varicella-zoster viruses spread rapidly through the blood, cerebrospinal fluid and nerve sheaths when ingestedperson. If they have settled in the nerve cells of the spinal ganglia, they will persist there for life. Since they have a tropism for the cells of the nervous system, varicella-zoster viruses cause diseases that often proceed as an infectious disease of the central and peripheral nervous systems.
Life-long hidden carriage of varicella zoster is established in about 20% of the inhabitants of our country who had chicken pox in childhood. Asymptomatic carriage of the "dormant" virus can be lifelong. The main refuge for him are the nerve cells of the body. Under the action of internal and / or external agents, the virus is activated.
Injuries, stressful conditions, hypothermia, infectious and somatic diseases can also activate herpes. The pathological anatomy of the disease in its classical form is an inflammatory process in the spinal ganglia and in the areas of the skin adjacent to them. Sometimes the process may involve the anterior and posterior horns of the gray matter, the roots of the spinal cord, the soft membranes of the brain.
The disease develops gradually, with common symptoms: dyspeptic disorders, headache, fever, malaise and chills. In the future, itching and burning of the skin, rashes join. The intensity of these manifestations in each patient may vary.
After a short prodromal period, there is a sharp rise in temperature and symptoms of intoxication (loss of appetite, muscle pain). At the same time, a painful rash appears on the skin in the form of pink spots,with a diameter of 2-5 mm. Very often, herpes zoster occurs on the back. Children may develop catarrhal inflammation of the respiratory tract (laryngitis, pharyngitis, rhinitis), which significantly complicates the course of the disease.
How dangerous is herpes zoster?
Shingles, despite its prevalence, is considered a very dangerous pathology. In addition to neuralgia, numerous other complications are possible. With the development of rashes, ulcers can form, which leave scars and scars on the skin. This is due to deep damage to the skin.
But the main danger of herpes zoster is the development of meningoencephalitis, which causes intense headaches, vomiting, photophobia, and possible loss of consciousness. Such a disease often leads to disability of the patient. Herpes zoster is especially dangerous in the elderly.
With lesions of the eyes and facial nerve, the patient may develop serious consequences in the form of blindness or glaucoma. In certain cases, herpes zoster can provoke the development of viral hepatitis and pneumonia.
The presence of the virus in the female body often leads to cervical erosion, problems with pregnancy, infertility and cancer.
Recurrent herpes in a man's body causes a weakening of the immune system, which creates positive conditions for the development of many diseases. In men, prostatitis, vesiculitis, epididymo-orchitis andbacterial urethritis.
Neonatal herpes can result in serious neurological pathologies and even death. Often the consequences of such a viral infection in children are meningoencephalitis and hydrocephalus, affecting the brain. So, let's find out how herpes zoster is treated.
Therapy of disease
Etiotropic therapy of the pathological process is based on the use of selective inhibitors of viral DNA production, for example, acyclovir. Such treatment is effective in the initial stages of the disease. The drug "Acyclovir" is prescribed intravenously, in a daily dosage of 15-30 mg / kg, which is divided into three injections with an interval of 8 hours. A single dose is diluted in isotonic solution. When prescribing tablet forms of this remedy, a single dose is 800 mg 5 times a day for 5 days.
It is not always possible to quickly treat herpes zoster with medicines. Pathogenetic therapy is based on the intake of dipyridamole, which slows down the processes of platelet aggregation. The course of treatment with this drug substance should be at least 5-7 days. Furosemide is prescribed for dehydration. To activate immunogenesis, homologous use of immunoglobulin (via intramuscular injection) is recommended.
Symptomatic therapy for this disease is prescribed individually, and it depends on the severity of its course. To do this, use analgesics, restorative and antipyretic drugs, for sleep disorders - hypnotics and sedatives, in somecases, antidepressants. If the signs of intoxication are pronounced, detoxification treatment with forced diuresis is carried out.
Locally, rashes are treated with a solution of brilliant green, and during the period of crusting - with dermatol ointment. When a secondary bacterial infection is attached, a course of antibiotic therapy is prescribed. What is the treatment for herpes zoster, the doctor will tell.
Drug Review
The main medications for herpes zoster are:
- "Aciclovir";
- "Famciclovir teva";
- "Amixin";
- "Viferon" (means to enhance immune defense).
The following types of medicines are used in the complex:
- antiherpetic;
- painkillers;
- antiviral;
- immunomodulating;
- anti-inflammatory;
- relieves itching.
Aciclovir
This medication is an antiviral agent for parenteral, internal, external and topical use. In the treatment of this type of herpes, it is usually used in the form of tablets "Acyclovir 200 mg". It is a synthetic analog of the acyclic purine nucleoside. The drug has increased specificity against Herpes simplex viruses (HSV), Epstein-Barr virus (EBV), cytomegalovirus (CMV) and Varicella zoster virus (VZV). The highest activity of the main substance is observed in relation to HSV-1.
The mechanism of action of "Acyclovir" in herpes zoster is duepenetration of the active element directly into cells infected with the virus and producing viral thymidine kinase, as a result of which it is phosphorylated to acyclovir monophosphate. The functionality of the thymidine kinase of the virus in relation to acyclovir is much higher than the effect of intracellular enzymes on it (the volume of acyclovir monophosphate in cells is 40–100 times higher). Subsequently, the formation of acyclovir triphosphate occurs, which is a selective and extremely active inhibitor of viral DNA polymerase.
According to the instructions, parenterally and orally "Acyclovir 200 mg" is prescribed for the treatment of the following pathologies: recurrent and primary genital herpes of severe forms, herpes zoster (Varicella zoster), herpes simplex with lesions of the skin and mucous membranes (Herpes simplex 1 virus and 2 types), herpes zoster with eye involvement.
Contraindications
What is the treatment for herpes zoster, it is better to find out in advance, because the drugs have quite a few contraindications. The drug "Acyclovir" is not prescribed, if available:
- hypersensitivity to ingredients;
- lactase deficiency, glucose-galactose malabsorption;
- under 3 years of age;
- lactation period.
Famciclovir teva
This is a drug that is produced on the basis of the substance of the same name famciclovir. It is an antiviral agent. After oral administration, famciclovir is rapidly converted to penciclovir, which has activity againsthuman herpes viruses, as well as cytomegalovirus and Epstein-Barr virus.
Penciclovir penetrates into infected cells, where, under the influence of viral thymidine kinase, it is rapidly converted to monophosphate, which, with the participation of cellular enzymes, is converted to triphosphate. Penciclovir triphosphate stays in infected cells for more than 12 hours, inhibiting the production of viral DNA in them. The concentration of this substance in uninfected cells is not higher than the minimum detectable, therefore, in therapeutic doses, penciclovir does not affect uninfected cells.
The drug Famciclovir significantly reduces the duration and intensity of postherpetic neuralgia in people with herpes zoster.
For the treatment of herpes zoster, it is recommended to take this medication at a dose of 250-500 mg. The duration and frequency of administration depend on the indications, kidney function, immune status, and the effectiveness of therapy.
The medicine should be taken as soon as possible after the onset of pathological symptoms, as in this case the therapy will be more effective.
Amiksin
This drug for the treatment of herpes zoster in adults and children belongs to the category of antiviral drugs. It is a fairly effective synthetic inductor that stimulates the body's natural synthesis of interferons belonging to the alpha, beta and gamma types. The main active element of the "Amiksina" remedy is tiporon. Hepatocytes (hepaticcells), granulocytes (white blood cells), T-lymphocytes (thymus cells), and intestinal epithelial cells.
When the drug enters the body, they begin to actively produce interferons, the maximum amount of which is produced within 24 hours. The drug has immunomodulatory and antiviral properties. Its use is effective against the background of the treatment of many infections of viral origin, including herpes, influenza, respiratory infections, and hepatitis viruses. The antiviral effect of the drug is due to its ability to inhibit the reproduction of pathogens by inhibiting the translation of virus proteins in infected cells.
Amixin remedy for herpes zoster is prescribed according to the following scheme: the first 2 days - 1 tablet, then - 1 tablet once every two days. In total, the patient should take 10-20 tablets for the course of therapy, depending on the severity of the course of the pathological process.
Viferon
Since herpes zoster appears with weakened immunity, "Viferon" helps to recover from the disease in a short time. This medication is allowed to be used in pediatrics, during pregnancy. However, despite the high effectiveness of the remedy, self-treatment is contraindicated for them.
The main element in the composition of the drug is interferon - protein cells that do not allow viruses to multiply. In addition to interferon, ascorbic acid and tocopherol-alpha are present in the drug. "Viferon" is producedin the form of ointments, gels and rectal suppositories.
In general, what to smear herpes zoster, and the scheme of therapeutic measures must be agreed with the doctor. Candles are considered more effective than ointment and gel. They are applied rectally, the dosage depends on the weight and age of the patient. For adults, the medication is prescribed in the morning and in the evening, one suppository at a dose of 500 thousand IU. It is very important to use this remedy within 5 days. Externally applied ointment "Viferon", it is recommended to lubricate rashes on the skin.
To make the treatment of this pathology as effective as possible, it is recommended to start taking it as early as possible. In addition, complex therapy is important - a combination of "Viferon" and antiviral agents.
This medicine has practically no contraindications and no side effects. In rare cases, a slight burning sensation may occur at the site of application of the ointment.
Painkillers
Find out why we need painkillers for herpes zoster. In addition to medications that directly eliminate the virus, medications are often prescribed that relieve pain. They are most often appointed as:
- "Analgin";
- "Paracetamol";
- "Nurofen";
- "Indomethacin";
- Butadion.
If the pain is too severe and persists for a long time, some anticonvulsants such as Gabapentin or Diazepam may be used. Combined with tabletsuse capsation-based ointments and lidocaine gels.
In severe cases, the doctor may recommend strong pain medications from the category of narcotic drugs or antidepressants. They are "Promedol", "Fortral", "Tramal", etc. Such drugs should be used strictly under the supervision of a specialist and only if there are appropriate symptoms. What other drugs are used to treat herpes zoster in adults?
Immunomodulatory substances
Herpes zoster should also be treated with immunomodulatory drugs. They are prescribed in addition to antiviral treatment, and their action is aimed at suppressing the activity of the zoster virus.
Since the task of such medicines is the artificial stimulation of the patient's immune cells, they must be prescribed only in accordance with the indications, and used according to the indicated scheme.
Preparations of this group can be natural and synthetic. Both those and others actively use herpes zoster in the disease. In the treatment of pathologies provoked by herpes viruses, they have a good effect:
- "Lavomax" is a medicine based on the active element of tilorone, which is obtained as a result of the synthesis of interferon. The drug is produced in tablet form, it is contraindicated in lactation, pregnancy and under the age of 18 years. Negative phenomena that occur during the reception are insignificant. These are dyspeptic disorders, allergies and short-term chills.
- "Proteflazid" is a medicine in the form of drops, based onlie flavonoids of wild cereals that can suppress the DNA of viruses. The drug not only improves local immunity, but also has antioxidant properties, helps to eliminate lipid oxidation products. With caution, the drug is used during pregnancy. Contraindications to it are peptic ulcer of the gastrointestinal tract during the period of exacerbation and sensitivity to the components.
Medicines for topical application
How else is herpes zoster treated? People often suffer not only from pain, but also from severe itching that occurs in the rash area. Therapy of this pathology requires the use of appropriate medications.
As a rule, they are gels, ointments and creams based on acyclovir:
- Zovirax;
- Gerpevir;
- Virolex;
- Gerperax and others
The category of anti-itch remedies for herpes zoster also includes medicines containing other active substances. These are, for example, "Viru-Merz Serol", which is based on tromantadine hydrochloride, "Panavir" with plant extracts, "Fenistil Pencivir" based on penciclovir and others.
