Sore Treatments

Herpes labialis (cold sore or fever blister) is a painful and highly contagious infection caused by the herpes simplex type 1 virus (HSVl). The herpesviruses are a large group of double-stranded DNA viruses that cause a variety of diseases in humans and animals. One of the interesting features of some herpesviruses is their ability to remain latent ( lying dormant ) in the body for long periods of time after the primary infec- 

Viruses (from the Latin virus referring to poison) are nonliving obligate intracellular parasites composed of protein and nucleic acid (DNA or RNA) that manipulate the host cell to produce and manufacture more viruses. Viral infection occurs by tire attachment of virus particles to specific cell receptors within the host cell. After fusion of the host cell plasma membrane with the virus outer envelope, the protein-based viral nucleocapsid (containing the viral DNA) is transported to the host cell nucleus, where components of the viral particle inhibit macromolecular synthesis by tire host cell. Herpes viral DNA and new viral nucleocapsid synthesis occurs within the host nucleus, with the acquisition of new viral envelopes via a budding process through the inner membrane of the host nucleus. The mature newly synthesized viral particles are subsequently 

On initial contact with HSVl, it is estimated that more than 90 percent of humans develop primary herpes. After the primary infection, most humans usually develop specific antibodies. However, despite the presence of these protective antibodies, many adults have repeated cold sore infections. Sores may develop as late as twenty days after the initial exposure to the virus. Herpes viruses are considered extremely contagious. In ancient Rome, an epidemic of cold sores prompted Emperor Tiberius to ban kissing in public ceremonies. It is estimated that more than 100 million episodes of recurrent cold sore outbreaks occur annually within the United States alone. 

While for most adults and children, cold sores generally clear up without treatment in seven to ten days, pain may be alleviated by home remedies such as avoiding spicy or acidic foods, applying ice or warmth to the blisters, or applying a moistened tea bag to the area, as it has been suggested that tannic acid (a chemical found in tea) may possess antiviral properties. Unfortunately, the HSVl infection itself cannot be cured. It is recommended that patients wash blisters gently with soap and water and dry thoroughly to prevent secondary bacterial infections. 

Over-the-counter topically applied medical treatments often contain anesthetic-like numbing agents that temporarily inactivate nerve endings in the skin, such as phenol (C H jO), camphor, benzyl alcohol (CyHgO), 

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Expectorant drug product Fever blister and cold sore treatment drug product Insect bite and sting drug products... 

In 1912, however, (201) it was discovered that espundia (American mucocutaneous leishmaniasis) can be cured by tartar emetic. It was soon learned that kala-a2ar (visceral leishmaniasis) and oriental sore (a cutaneous form of the disease occurring in the Middle East) also respond to antimonial therapy, especially when compounds of pentavalent antimony are employed. Treatment of leishmaniasis with the latter type of antimonials is safe and effective in over 90% of the cases (202). In 1918, it was demonstrated that tartar emetic is of value in the treatment of schistosomiasis (203). Pentavalent antimonials proved to be less effective. The introduction of antimony compounds for the treatment of parasitic diseases is undoubtedly one of the important milestones in the history of therapeutics (see Antiparasitic agents). 

Umbellatine was examined by Gupta and Kahali, who found that it killed Paramoecium at 1 in 500 and Leishmania tropica at 1 in 50,000, but did not inhibit L. donovani or Entamoeba histolytica at 1 in 10,000. It remembles berberine in the nature and range of its pharmacological activity but is more active in producing cardiovascular response and is possibly more potent in the treatment of oriental sore. 

Acyclovir (Zovirax) and penciclovir (Denavir) are the only topical antiviral dragp currently available These dragp inhibit viral replication. Acyclovir is used in the treatment of initial episodes of genital herpes, as well as heqies simplex virus infections in immunocompromised patients (patients with an immune system incapable of fighting infection). Penciclovir is used for the treatment of recurrent herpes labialis (cold sores) in adults. 

Acute pharyngitis presents a diagnostic and therapeutic dilemma. The majority of sore throats are caused by a variety of viruses fewer than 20% are bacterial and hence potentially responsive to antibiotic therapy. However, antibiotics are widely prescribed and this reflects the difficulty in discriminating streptococcal from non-streptococcal infections clinically in the absence of microbiological documentation. Nonetheless, Strep, pyogenes is the most important bacterial pathogen and this responds to oral penicillin. However, up to 10 days treatment is required for its eradication fixm the throat. This requirement causes problems with compliance since symptomatic improvement generally occurs within 2-3 days. 

Systemic antibiotics are indicated for pressure sores associated with spreading cellulitis, osteomyelitis, or bacteremia. Because the infections usually are polymicrobial, antibiotic therapy should target gram-positive, gram-negative, and anaerobic bacteria. The duration of treatment is generally 10 to 14 days, unless osteomyelitis is present.38... 

See Table 47-4 for systemic treatment of an infected pressure sore. A short, 2-week trial of topical antibiotic (silver sulfadiazine or triple antibiotic) is recommended for a clean ulcer that is not healing or is producing a moderate amount of exudate despite appropriate care. 

Phenol is both a man-made chemical and produced naturally. It is found in nature in some foods and in human and animal wastes and decomposing organic material. The largest single use of phenol is as an intermediate in the production of phenolic resins. However, it is also used in the production of caprolactam (which is used in the manufacture of nylon 6 and other synthetic fibers) and bisphenol A (which is used in the manufacture of epoxy and other resins). Phenol is also used as a slimicide (a chemical toxic to bacteria and fungi characteristic of aqueous slimes), as a disinfectant, and in medicinal preparations such as over-the-counter treatments for sore throats. Phenol ranks in the top 50 in production volumes for chemicals produced in the United States. Chapters 3 and 4 contain more information. 

The full spectrum of depressive symptoms including depressed mood, anhedonia, lack of energy, and even suicidal thoughts may strike as many as 25% of patients who experience a TBL Depression in these patients not only exacts a tremendous psychosocial toll but also interferes with their participation in physical and occupational rehabilitation. As a result, long-term functional recovery from TBl can be sorely compromised by depression. Potential treatments for post-TBl depression include conventional antidepressants and stimulants (see Table 12.1). 

Aciclovir is an antiviral indicated in the treatment and prophylaxis of cold sores. It is available for systemic administration (tablets) or topical use (cream, eye ointment). In the management of cold sores, the cream is applied every 4 hours and continued for 5 days. Its use should be started as soon as symptoms (tingling sensation) begin. 

Side-effects of corbamazepine include blood disorders such as thrombocytopenia, leucopenia, aplastic anaemia and agranulocytosis. Patients ore therefore advised to stop treatment and contact a healthcare provider if they develop symptoms of sore throat, fever, rash, mouth ulcers, bleeding or bruising. 

Also known as the pharmacy or, in the United Kingdom and other parts of the world, the chemist s, a drugstore is our source for literally thousands of chemicals that can he used to improve our health and well-being. And each year, dozens of new chemical compounds are added to that list of lifesaving and life-improving substances. These compounds include products for the relief of pain, the treatment of allergies and stomach disorder, protection from environmental hazards, cure of infectious diseases, alleviation of body aches and sores, the remedy for poisonous bites and toxic chemicals, and a host of other beneficial results. 

Ulcerating lesions Topical treatment of ulcerating lesions of the oral cavity, such as recurrent aphthous stomatitis (canker sores). 

Not intended for the treatment of vesicular lesions, such as cold sores or fever blisters. 

Herpes labialis For the treatment of herpes labialis (cold sores). 

Herpes labialis The recommended dosage of valacyclovir for the treatment of cold sores is 2 g twice daily for 1 day taken approximately 12 hours apart. Initiate therapy at the earliest symptom of a cold sore (eg, tingling, itching, burning). There are no data on the effectiveness of treatment initiated after the development of clinical signs of a cold sore (eg, papule, vesicle, ulcer). Therapy beyond 1 day does not appear to provide additional clinical benefit. 

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