STIs Therapy and Education
QUESTION
J.R. is a 36-year-old white, middle-class woman who has been sexually active with one partner for the past 2 years. She and her partner have no history of STIs, but her partner has a history of fever blisters. She reports genital pain, genital vesicles and ulcers, and fever and malaise for the last 3 days. Examination reveals adenopathy and vaginal and cervical lesions.
1). What drug therapy would you prescribe? Why?
2). What are the parameters for monitoring the success of the therapy?
3). Discuss specific education for J.R. based on the diagnosis and prescribed therapy.
STIs Therapy and Education
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STIs Therapy and Education
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STIs Therapy and Education
Question 1
Based on the patient’s presented symptoms, it is most likely she is suffering from herpes simplex. In their symptomatic stage, Herpes Simplex virus infection is characterized by painful ulcers or blisters at the infection site ranging from mild to severe (World Health Organization, 2021). J.R’s symptoms are severe hence the priority medication for her is intravenous Acyclovir, which is an antiviral drug for genital herpes (Taylor & Gerriets, 2021). The prescription for J.R is 10mg of acyclovir after every 8 hours, for up to seven days. In addition to this, J.R should be prescribed an oral dose of acyclovir at 400mg three times a day per one-kilogram body weight for up to 10 days (Johnston, 2022). This is to address the presented symptoms of herpes which can worsen if left untreated.
Question 2
In monitoring the success of acyclovir therapy, the size and the condition of genital vesicles and ulcers should be monitored as the patient progresses with the therapy. Additionally, the patient’s body immunological response can be used to monitor the progression of acyclovir therapy (Taylor & Gerriets, 2021). The patient’s symptoms are expected to improve with therapy administered failure to which a physician should consider other therapies. Techniques such as computerized abdominal tomography combined with ultrasonography should be used to the identification of the causative virus and allow the assessment of therapy success (Ady & Fong, 2014).
Question 3
Firstly, J.R should be informed that genital herpes does not have a cure but there are medications to prevent the virus. J.R should be informed to abstain from sex in the meantime until the genital vesicles and ulcers have completely healed. This will prevent the transmission of the condition to her partner. The patient should also be informed of the side effects of using acyclovir therapy such as nausea, headaches, diarrhea, and body weaknesses (Paluch et al., 2021). Acyclovir can also cause adverse side effects including phlebitis and should be advised to inform the care providers in case of severity.
References
Ady, J., & Fong, Y. (2014). Imaging for infection: from visualization of inflammation to visualization of microbes. Surgical infections, 15(6), 700-707.
Johnston, C. (2022). Diagnosis and Management of Genital Herpes: Key Questions and Review of the Evidence for the 2021 Centers for Disease Control and Prevention Sexually Transmitted Infections Treatment Guidelines. Clinical Infectious Diseases, 74(Supplement_2), S134-S143.
Paluch, Z., Trojánek, M., Velíšková, Z., Mlíchová, J., Chrbolka, P., Gregorová, J., … & Pícha, D. (2021). Neurotoxic side effects of acyclovir: two case reports. Neuroendocrinology Letters, 42(6).
Taylor, M., & Gerriets, V. (2021). Acyclovir. In StatPearls [Internet]. StatPearls Publishing.
World Health Organization. (2021). Guidelines for the management of symptomatic sexually transmitted infections. World Health Organization.