Priya (Chicken Pox)

PHARMACOTHERAPEUTICS 2 PRESENTATION
PRESENTED BY S.PRIYA
PHARMD 3rd YEAR
21DQ1TOO24
CASE PRESENTATION ON CHICKEN POX

SUBJECTIVE FINDINGS
DEMOGRAPHIC DETAILS :-
A 10years old boy admitted in hospital for evaluation and treatment of recurrent chicken pox.
CHIEF COMPLAINTS :-
Episodes of vomiting since 4 days
Overt ataxia with abnormal cerebellar signs
Lesions on face , neck , chest, and back
SOCIAL HISTORY :- None

FAMILY HISTORY:- None
MEDICATION HISTORY :-None
PAST MEDICAL HISTORY :-
*Mild case of chickenpox at the age of 4years and received no vaccination for it.
*10 day history of progressive vesicular and pustular lesions that began on his neck and spread to his
back, trunk, extremities, and face.
*from past 3days he was febrile ( upto 40.5 degree celcius orally).
OBJECTIVE FINDINGS
*Had overt ataxia with abnormal cerebellar signs.
*Lesions consistent with VZV (varicella zostera virus) infection were extensive and confluent over
the face, neck, chest, and back.
*Lesions varying from tiny thin walled vesicles with erythematous base , few lesions were crusted.
* New lesions were noted on second day of acyclovir therapy.
LABORATORY TEST :-
Blood analysis
TEST TEST VALUES NORMAL VALUES
BUN(blood urine nitrogen) 9mg/dl 5-8mg/dl
Serum creatinine 0.2mg/dl 0.5- 6.8 mg/dl
Serum aspartate aminotransferase 65 IU 0-34 units/L
Serum alanine aminotransferase 122 IU 0-34 units/L
From above blood analysis it shows that the levels of serum aspartate aminotransferase and serum alanine amino
transferase is increased . The levels of serum creatinine has decreased.
ASSESSEMENT
PROVISIONAL DIAGNOSIS:-
Based on subjective and objective findings the provisional diagnosis is Recurrent chicken pox ( i.e.
primary VZV varicella zoster virus) infection.
FINAL DIAGNOSIS :-
CHICKEN POX
CHICKEN POX
Chickenpox, or chicken pox, also known as varicella,is a highly contagious, vaccine-preventable disease caused by the
initial infection with varicella zoster virus (VZV), a member of the herpesvirus family. It usually starts on the chest, back, and
face. It then spreads to the rest of the body.
ETIOLOGY
Chickenpox is an airborne disease which easily spreads via human-to-human transmission, typically through the coughs
and sneezes of an infected person. The incubation period is 10–21 days, after which the characteristic rash appears. It may
be spread from one to two days before the rash appears until all lesions have crusted over. It may also spread through
contact with the blisters. It’s very contagious and spreads through bodily fluids and bodily contact. You can prevent chickenpox with a
vaccine.
SYMPTOMS
the first sign is the rash or the spots in the oral cavity. The rash begins as small red dots on the face, scalp, torso, upper
arms and legs; progressing over 10–12 hours to small bumps. Symptoms of chickenpox usually happen in the following order:
• Low-grade fever.
• Feeling tired.
• Headache.
• A stomachache that makes you not want to eat.
• A skin rash that’s very itchy and looks like many small blisters.
• Bumps filled with a liquid that looks like milky water.
PATHOGENESIS
DIAGNOSIS
The most sensitive method for confirming a diagnosis of varicella is the use of polymerase chain reaction (PCR) to
detect VZV in skin lesions
ELISA is the most commonly used test to determine if a person has antibodies to VZV from past varicella disease .
Plan of treatment
GOAL OF THERAPY:-
*To improve or reduce ataxia
*To provide vaccine
*To decrease further new lesions formation on body
*To heal the lesions
*Reduce signs and symptoms
*To avoid spread of infection from one person to other
*To improve quality of life through vaccination
*Remedies to reduce itching.
NON PHARMACOLOGICAL TREATMENT:-

*Proper diet plan
*calamine lotion to get relief from itching
*Cool bath with baking soda
*Washing hands often
*scratching of hands should be avoided
*maintaining body temperature through aerobic exercise
PHARMACOLOGICAL TREATMENT:-
DRUGS MECHANISM OF ROUTE OF FREQUEN DOSE THERAPEUTIC USES ADVERSE DRUG
ACTION ADMINISTR CY REACTIONS
ATION
*Acyclovir It competitively IV every 8 BD 300mg Use to treat chicken pox, *diarrhoea

inhibits viral DNA hours shingles, HSV of genitals *vomiting
polymerase by etc. *headach
acting on DGTP
*diphenhydramin It act as inverse Orally BD 50mg Use to relief redness, *confusion

e agonist of H1 irritation , itchiness , *hepatomegaly
receptors. Which watery eyes , sneezing , *hallucination
reduces allergic hay fever, pruritis, * tachycardia
reactions utricaria etc.
TOXICITY MONITORING :-
*Acyclovir:-
- swelling of hands , feets, ankles , lower legs etc
- Induce neurotoxicity
- Impair renal functions
- psychiatric changes
*Diphenhydramine:-
- confusion
- dry mouth
- tachycardia
-blurred vision
DRUG INTERACTIONS:-
Acyclovir + Abacavir decrease excretion of abacavir leads to higher serum levels
Acyclovir + Food decrease absorption of acyclovir
Acyclovir + NSAID renal problems
MONITORING PARAMETERS
*Monitor signs and symptoms
*monitory body temperaure
*follow up serological evaluation.
PATIENT COUNSELLING
*maintaining hygienic conditions

*Drinking plenty of water
*avoid scratching of hands and legs
*apply calamine lotions regularly
*proper diet plan
PHARMACIST INTERVENTIONS
*Regular follow up
*vaccinations
THANK
YOU!

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PHARMACOTHERAPEUTICS 2 PRESENTATION

CASE PRESENTATION ON CHICKEN POX

SOCIAL HISTORY :- None

BUN(blood urine nitrogen) 9mg/dl 5-8mg/dl

Serum creatinine 0.2mg/dl 0.5- 6.8 mg/dl

Serum aspartate aminotransferase 65 IU 0-34 units/L

Serum alanine aminotransferase 122 IU 0-34 units/L

NON PHARMACOLOGICAL TREATMENT:-

Acyclovir It competitively IV every 8 BD 300mg Use to treat chicken pox, diarrhoea

diphenhydramin It act as inverse Orally BD 50mg Use to relief redness, confusion

*maintaining hygienic conditions

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