The Hip: Preservation, Replacement and Revision


- See: Herpes Simplex Finger Infection

- Discussion:
    - adult w/ initial Herpes simplex infecction infection:
            - 200mg PO q4h while awake (5 caps/day) for 10 days;
            - or 5mg/kg IV over 1hr q8hr x 5days, or 1gm/day in 5 divided doses PO for 10 days;
            - or 5% topical ointment 4-6 times/day for 7-14 days;
    - peds: 30 mg/kg/day q 8hr;
    - will increase rate of lesion healing, but does do not prevent recurrence;
    - chronic suppresive therapy for recurrent disease:
            - 200 mgPO tid for up to 6 months;
            - or better 1gm/day in 5 divided doses PO for 5 days;
    - daily rx for 4 months decreases but does not prevent recurrences;
    - may apply ointment for up to 6 times a day for 7 days;

- Side Effects:
    - may cause Renal Impairment; adequate hydration essential to prevent renal tubular crystallization;
    - encephalopathic reactions have been reported;
    - side effects include transient burning, N, V, D, HA;
    - not for use in the eye;
    - interactions: w/ probenecid and sulfinpyrazone and zidovudine: to increase toxicity of acyclovoir, marked lethargy;

- IV Use:
    - for mucocutaneous lesions in immunocomprimised host: 6.2mg/kg or 250mg/Msq IV over 1hr q8hr for 7 days;
    - herpes zoster (normal host): 5-10mg/kg IV over 1hr q8hr for 5 days;
    - IV use for Herpes in the immunocomprimised patient:
           - 5mg/kg IV infused slowly over 1 hr q8hr (15mg/kg each day) for 7 days;
           - for severe initial episodes of genital herpes for 5 days;

- Renal Dosing:
    - decrease dosage in Renal patients and contraindicated with hypersensitivity;
    - renal (5%): increase creatinine, hematuria;
    - with high doses, crystalizes in renal collecting tubules leading to obstructive uropathy; Hepatic: Inc SGOT, SGPT;

- Alternative Medications:
    - valacyclovir: 1000 mg every eight hours
    - famciclovir: 500 mg every eight hours

Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Friday, November 30, 2012 12:57 pm