· Acyclovir is known to be a deoxyguanosine analogue.

·       
Medication for first episode of
Genital Herpes:

The number of antiviral medications against the
first episode of Genital Herpes are many. Genital Herpes is usually
characterized as HSV – 1 and HSV – 2. It is understood that all other
medications are nucleoside analogues except foscarnet and cidofovir. The major
three medications namely acyclovir, famciclovir and valaciclovir are considered
as effective medications against HSV – 1 and HSV – 2. Other antiviruses mentioned
above, such as cidofovir, foscarnet, ganciclovir and valganiciclovir have also
helped greatly in combating the first episodes of genital herpes. These are
also useful against alpha herpes virus. They are used in special conditions
such as treatment of some acyclovir – resistant HSV isolates.

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Acyclovir:

It is a prototypic antiviral agent. It
activates viral induced enzyme thymidine kinase in the initial stages of the
first episode. The activity of acyclovir against VZV is ten times less than
it’s activity against HSV. On the other hand, Epstein Barr Virus has minimal thymidine
kinase activity because of it’s moderate susceptibility towards acyclovir.

Mechanism
Of Action:

Acyclovir is known to be a deoxyguanosine
analogue. It has an acyclic side chain that lacks a 3 – hydroxyl group from the
group of natural nucleotides. Since the missing group is required for the
growth of DNA, the growth gets terminated. Hence, the viral DNA polymerase gets
inactivated. This is where acyclovir comes into action. It is much more
effective and a better substrate to for the viral polymerase instead of
cellular DNA polymerase. The end result is the incorporation of acyclovir into
cellular DNA.

·       
Medication for recurrent
episode of Genital Herpes:

An effective treatment for reoccurring
episodes of Genital herpes is intravenous acyclovir therapy. The treatment is
used when the patient encounters severe episodes of HSV or is hospitalized due
to an escalated situation. A total of 5 – 10 mg/kg IV every eight hours for
about 2-7 days is the recommended regiment. This may it may not be continued
beyond 7 days which depends upon the clinical observation. Then follows an oral
antiviral therapy which is to be undertaken for at least 10 days after the
total therapy. HSV encephalitis is an intravenous therapy that requires a
minimum of 21 days. Adjustment in the acyclovir dosage is confirmed with an
impaired renal function.

Like every other medication that is
synthesized, acyclovir has it’s own set of allergies and adverse reactions that
are different in different individuals. They are not completely absent, the
allergies and side effects are rare. Researchers have also found desensitization
of acyclovir.