QuestionSBA
QuestionChoice
Foscarnet is an antiviral drug with activity against some herpesviruses such as CMV. It has no role in the acute management of shingles
33992
c
Foscarnet 40mg/kg IV TDS
QuestionChoice
Duloxetine is an SNRI used to treat neuropathic pain. It has no role in the acute management of shingles but can be prescribed to treat post-herpetic neuralgia
33991
b
Duloxetine 60mg PO OD
QuestionChoice
This patient is presenting with shingles. Oral acyclovir has been shown to reduce the duration and intensity of symptoms, but not to reduce the incidence of post-herpetic neuralgia
33990
a
Aciclovir 800mg PO 5 times a day
QuestionChoice
Paracetamol may provide some pain relief from symptoms but does not treat shingles itself
33994
e
Paracetamol 1g PO QDS
QuestionChoice
Gabapentin is used to treat neuropathic pain and some types of seizures. It has no role in the acute management of shingles but can be prescribed to treat post-herpetic neuralgia
33993
d
Gabapentin 300mg PO OD
QuestionComment
I thought you could only give Acyclovir if within 72 hours, wouldn't a 3 day history potentially be over this?
38489
User
subscriber
Relapse Complement
QuestionComment
only treat is pain is moderate or severe or weakened immune system, pt reports neither of these?
61065
QuestionComment
'Consider oral antiviral treatment for patients aged over 50 years to reduce the risk of post-herpetic neuralgia.' under 'Herpesvirus infections' treatment summary
61414
User
subscriber
Myopathy Prone
User
subscriber
Ortho bro
Concept
Chapter
#### Monitoring

The BNF advises to monitor lung function (in patients with a history of obstructive airway disease).

#### Overdoses

Overdosages with beta-blockers may cause cardiac effects such as bradycardia, hypotension, syncope, conduction abnormalities, and heart failure. Bradycardia is the most common arrhythmia, but some beta-blockers may induce ventricular tachyarrhythmias secondary to prolongation of QT interval (e.g. sotalol) or QRS duration (e.g. propranolol).
Non-cardiovascular effects include central nervous system effects (including drowsiness, confusion, convulsions, hallucinations, and in severe cases coma), respiratory depression, and bronchospasm.

Management
 - Airway protection 
 - Activated charcoal within 1 hour
 - IV Fluids
 
IV glucagon is the first-line management.
 
For symptomatic bradycardia, IV atropine may be used.

2618
2742
Shingles
Topic
74
Elderly Care
6809
Case Presentation: A 73 year old man attends his GP with a 3 day history of a painful rash. **PH** aortic abdominal aneurysm (<5.5cm), benign prostatic hypertrophy. **DH** tamsulosin hydrochloride 400 micrograms PO OD. NKDA


**O/E**

HR 70, RR 13, BP 132/65, O2 100% RA, Temperature 36.4°C. Erythematous vesicular rash on right side of abdomen in the distribution of T10 dermatome.

Question: Select the most appropriate management at this stage.
a