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Old 09-13-2011
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Question Zoster initial step, pain control or Acyclovir!

What is most important initial step in someone with a herpes attack.

FA-CK says pain control is most important.

UWorld says that give instant iv acyclovir - because it will result in rapid reduction of length of episodes.

So are we to ignore something like opiods and NSAIDs for instant relief of the neuropathic pain? (also confused about TCAs since they will take time to act.. right?)
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Old 09-13-2011
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Oral Acyclovir, not IV, unless its a complicated case.

for Pain control all you need to know is that you can use TCA, Gabapentin and Pregabalin.
you can also use Narcotics like oxycodone for severe pain, NSAIDs and Acetaminophen for minor pain, but they will not ask about that.

I dont think it is high yield to know which one to use first, but I would go with uWorld, especially if it is ophthalmicus or someone with depressed immune status
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Old 09-13-2011
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Quote:
Originally Posted by soulhead View Post
Oral Acyclovir, not IV, unless its a complicated case.

for Pain control all you need to know is that you can use TCA, Gabapentin and Pregabalin.
you can also use Narcotics like oxycodone for severe pain, NSAIDs and Acetaminophen for minor pain, but they will not ask about that.

I dont think it is high yield to know which one to use first, but I would go with uWorld, especially if it is ophthalmicus or someone with depressed immune status
Thanks it is really helpful.. i also found this.. which says the same thing as you do. I hope they give " gabapentin and acyclovir together" as a choice.

http://emedicine.medscape.com/articl...nt#aw2aab6b6b2
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Infectious-Diseases, Internal-Medicine-, Neurology-

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