Pharmaco-Therapeutics- ll

Assignment – 2

TOPIC :Management of

various viral infections

Shreya ThakkarPharm- D (third year)

Roll No. – 19K.B.I.P.E.R

What is viral infection A viral infection is a disease that can be caused by different kinds

of viruses, of which the influenza-virus is best known.

A viral infection can be in different places in the body, some viruses are mainly in the intestine, while others prefer the lungs and airways.

With a viral infection you usually have a fever, but other complaints can range from abdominal pain and diarrhea to coughing and shortness of breath.

Symptoms Fever Fatigue Headache Depending on the virus

o Coughingo Diarrheao Abdominal paino Sore throat

What can we do for viral infection1. Rest2. Hydrate3. Eat light foods (fruit, toast etc.)4. Prevent infecting others:

a. Wash your hands regularlyb. Don't leave used tissues and hankerchiefs lying around

5. Don't share cups, plates, cutlery

Is viral infection serious ?

Everyone has a flu or a bad cold once in a while, so a viral infection usually isn't serious.

Of course it can be very bothersome and unfortunately there isn't any properly effective medication to cure viral infection, antibiotics aren't effective either, because those focus on bacteria, not viruses.

Though a viral infection usually isn't serious, know when to see a doctor.

Contact a doctor:

Complaints lasting more than 7 days Fever longer than 5 days When you become short of breath

Immediately contact a doctor:

With a fever over 106.7 degrees Fahrenheit With new red spots or a new red rash on the skin When it hurts to put your chin to your chest, while turning your

head doesn't hurt The symptoms severly worsen

Types of various viral infection1. Common cold 2. Influenza (flu)3. Bronchitis 4. Gastroenteritis5. RSV (respiratory syncytial virus)6. Hepatitis A,B,C7. Dengue fever8. Measles9. Mumps10. SARS11. Smallpox12. HIV13. Herpes simplex virus infection 14. Some ear infections15. Rhinovirus

COMMON COLD : The common cold is a viral infection of the lining of the nose,

sinuses, throat, and large airways.

Usually, colds are spread when a person's hands come in contact with nasal secretions from an infected person.Colds often start with a scratchy or sore throat or discomfort in the nose, followed by sneezing, a runny nose, a cough, and a general feeling of illness.

Good hygiene, including frequent hand washing, is the best way to prevent colds.Rest, decongestants, antihistamines, cough syrups, and nonsteroidal anti-inflammatory drugs can help relieve symptoms.

Common colds are among the most common illnesses. Many different viruses cause colds, but rhinoviruses (of which there are 100 subtypes) are implicated more often than others.Colds caused by rhinoviruses occur more commonly in the spring and fall. Different viruses cause colds during other times of the year.These secretions contain cold viruses. When people then touch their mouth, nose, or eyes, the viruses gain entry to the body and cause a cold. Less often, colds are spread when people breathe air containing droplets that were coughed or sneezed out by an infected person. A cold is most contagious during the first 1 or 2 days after symptoms develop. Becoming chilled does not cause colds, nor does it increase a person's susceptibility to infection. General health and eating habits also do not seem to affect susceptibility to infection, nor does having an abnormality of the nose or throat (such as enlarged tonsils or adenoids)

INFLUENZA:Influenza (flu) is infection of the lungs and airways with one of the influenza viruses.It causes a fever, runny nose, sore throat, cough, headache, muscle aches (myalgias), and a general feeling of illness (malaise).The virus is spread by inhaling droplets coughed or sneezed out by an infected person or by having direct contact with an infected person's nasal secretions.Influenza often starts with chills, followed by a fever, muscle aches, headache, a sore throat, a cough, a runny nose, and a general feeling of illness.People can often diagnose influenza themselves based on symptoms, but sometimes samples of blood or respiratory secretions must be analyzed to identify the virus.An annual influenza vaccination is the best way to prevent influenza.Resting, drinking plenty of fluids, and avoiding exertion can help, as can taking pain relievers, decongestants, and sometimes antiviral drugs.Every year, throughout the world, widespread outbreaks of influenza occur during late fall or early winter. Influenza occurs in epidemics, in which many people get sick all at once.Influenza epidemics may occur in two waves: first in schoolchildren and the people who live with them and, second, in people who are confined to home or live in long-term care facilities, mainly older people.In each epidemic, usually only one strain of influenza virus is responsible for the disease.The name of a strain often reflects where it was first found: a location (for example, Hong Kong flu) or an animal (for example, swine flu).There are two types of influenza virus, type A and type B, and many different strains within each type. About 95% of influenza cases are caused by influenza virus type A.

The illnesses produced by the different types and strains are similar. The strain of influenza virus causing outbreaks is always changing, so each year the influenza virus is a little different from the previous year's. It often changes enough that previously effective vaccines no longer work.Influenza is distinctly different from the common cold. It is caused by a different virus and produces symptoms that are more severe. Also, influenza affects cells much deeper down in the respiratory tract.The influenza virus is spread by inhaling droplets that have been coughed or sneezed out by an infected person or by having direct contact with an infected person's nasal secretions.Handling household articles that have been in contact with an infected person or an infected person's secretions may sometimes spread the disease.

Symptoms and DiagnosisSymptoms start 1 to 4 days after infection and can begin suddenly. Chills or a chilly sensation is often the first indication.Fever is common during the first few days, sometimes reaching 102 to 103° F (about 39° C). Many people feel so ill, weak, and tired that they remain in bed for days. They have aches and pains throughout the body, particularly in the back and legs. Headache is often severe, with aching around and behind the eyes.Bright light may make the headache worse.At first, respiratory symptoms may be relatively mild. They may include a scratchy sore throat, a burning sensation in the chest, a dry cough, and a runny nose. Later, the cough can become severe and bring up phlegm (sputum). The skin may be warm and flushed, especially on the face. The mouth and throat may redden, the eyes may water, and the whites of the eyes may become bloodshot. People, especially children, may have nausea and vomiting. A few people lose their sense of smell for a few days or weeks. Rarely, the loss is permanent.Most symptoms subside after 2 or 3 days. However, fever sometimes lasts up to 5 days.

Cough, weakness, sweating, and fatigue may persist for several days or occasionally weeks. Mild airway irritation, which can result in a decrease in how long or hard a person can exercise, or slight wheezing may take 6 to 8 weeks to completely resolve.The most common complication of influenza is pneumonia, which can be viral, bacterial, or both. In viral pneumonia, the influenza virus itself spreads into the lungs. In bacterial pneumonia, unrelated bacteria (such as pneumococci or staphylococci) attack the person's weakened defenses. With either, people may have a worsened cough, difficulty breathing, persistent or recurring fever, and sometimes blood or pus in the sputum. Pneumonia is more common among older people and among people with a heart or lung disorder. In long-term care facilities, as many as 7% of older people who develop influenza have to be hospitalized, and 1 to 4% die. Younger people with a chronic disorder are also at risk of developing severe complications.Because most people are familiar with the symptoms of influenza and because influenza occurs in epidemics, it is often correctly diagnosed by the person who has it or by family members. The severity of symptoms and the presence of a high fever and body aches help distinguish influenza from a cold, especially when the illness occurs during an influenza outbreak.It is more difficult to correctly identify influenza by symptoms alone when no outbreak is occurring.Tests on samples of blood or respiratory secretions can be used to identify the influenza virus.Such tests are done mainly when people appear very ill or when a doctor suspects another cause for the symptoms. Some tests can be done in the doctor's office.

PreventionAnnual vaccination is the best way to avoid getting influenza. Influenza vaccines contain inactivated (killed) influenza virus or pieces of the virus and are given by injection. A newer vaccine, inhaled as a nasal spray, contains weakened live viruses. This vaccine is used only in healthy people aged 5 to 49 years. Influenza vaccines usually protect against three different strains of influenza virus.

Different vaccines may be given every year to keep up with changes in the virus. Doctors try to predict the strain of virus that will attack each year based on the strain of virus that predominated during the previous influenza season and the strain causing disease in other parts of the world.

Vaccination:

Vaccination is useful for most people but is particularly important for people who are likely to become very ill if infected.These people include the young (particularly those younger than 24 months), those older than 65, those with a weakened immune system, and those with a chronic disorder such as diabetes or a lung, heart, or kidney disorder.In older people who live in long-term care facilities, the vaccine is less likely to prevent influenza, but it reduces the chances of developing pneumonia and of dying. Other than occasional soreness at the injection site, side effects from the vaccine are rare.In the United States, vaccination takes place during the fall so that levels of antibodies are highest during the peak influenza months: November through March. For most people, about 2 weeks is needed for the vaccination to provide protection.Several antiviral drugs can be used to prevent infection with the influenza virus. Doctors may prescribe these drugs when people have had a clear, recent exposure to someone with influenza. These drugs are also given to people who have conditions that make vaccination ineffective or dangerous. The drugs are used during epidemics of influenza to protect unvaccinated people who are at high risk of complications of influenza: older people and people with a chronic disorder.

SOME TRADE NAMES Andrimantadine: are older antiviral drugs that provide protection

against influenza type A but not influenza type B. These drugs can cause stomach upset, nervousness, sleeplessness, and other side effects, especially in older people and in people with a brain or kidney disorder. Rimantadine: tends to have fewer side effects than amantadine

SYMMETREL: Another drawback of both amantadine is that the influenza virus rapidly develops resistance to them. During the 2005 to 2006 influenza season, concerns about resistance prompted the Centers for Disease Control and Prevention to discourage the use of these drugs for prevention and treatment. Two newer drugs, oseltamivirAndzanamivir (TAMIFLU)

RELENZA: can prevent infection with influenza virus type A or type B. These drugs have minimal side effects.

Treatment The main treatment for influenza is to rest adequately, drink plenty

of fluids, and avoid exertion. Normal activities may resume 24 to 48 hours after the body temperature returns to normal, but most people take several more days to recover. People may treat fever and aches with acetaminophenTYLENOLornonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirinBAYERoribuprofenADVIL MOTRIN. Because of the risk of Reye's syndrome, children should not be given aspirinBAYER. AcetaminophenTYLENOLandibuprofenADVIL MOTRINcan be used in children if needed. Other measures as listed for the common cold, such as nasal decongestants and steam inhalation, may help relieve symptoms.The same antiviral drugs that prevent infection (amantadineSYMMETREL, rimantadineFLUMADINE, oseltamivirTAMIFLU, andzanamivir

RELENZA: are also helpful in treating people who have influenza. However, these drugs work only if taken in the first day or two after symptoms begin, and they shorten the duration of fever and respiratory symptoms only by a day or so. Nevertheless, these drugs are very effective in some people. Most doctors recommend zanamivirRELENZAoroseltamivirTAMIFLU: which are effective against influenza type A and type B. If a bacterial infection develops, antibiotics are added.

BronchitisBronchitis Overview

Acute bronchitis is the sudden inflammation of the tracheobronchial tree, which comprises the trachea, or windpipe (tube that leads from the throat to the lungs) and the bronchi (bronchial tubes, air passages of the lungs).

It is typically associated with a viral upper respiratory tract infection (URI), such as the common cold, and is usually mild. In patients with chronic lung or heart disease, acute bronchitis is more severe, and can become chronic (chronic obstructive pulmonary disease [COPD]) and progress to pneumonia.

Infection causes the mucous membrane of the bronchial tubes to become inflamed and produce thick, sticky mucus. The overproduction of mucus reduces the normal defensive function (called clearing function) of the cilia, the small hairlike structures of the bronchial tubes responsible for moving secretions and debris out of the lungs.

Inflammation and accumulated mucus narrow the airways, restrict respiration, and promote bacterial infection.

The viruses that cause this condition are often transmitted when they are expelled through coughing, sneezing, and talking. They can also be transmitted through contact with infected drinking glasses and eating utensils.

Types of BronchitisAcute infectious bronchitis :

commonly accompanies or follows a URI; it develops over a couple of days, produces symptoms for 3 to 7 days, and resolves to a cough before normal respiratory function is recovered.

Acute irritative bronchitis is triggered by allergies and chemical and other types of environmental irritants.

Incidence & Prevalence of BronchitisAcute bronchitis is one of the most common conditions treated by primary-care physicians. Incidence is highest in the winter. It frequently affects people who suffer from allergies, other respiratory illnesses, chronic sinusitis, chronic tonsillitis, infected adenoids, and smokers.

Causes & Risk Factors for BronchitisThe most common viruses associated with bronchitis are influenzavirus types A and B, which cause influenza; and rhinovirus, parainfluenza, and coronavirus, which cause the common cold.

Viral infection may create an environment in which bacterial infection also can develop. Bacterial infection with Mycoplasma pneumoniae, Clamydiapneumoniae, and Bordetella pertussis (whooping cough), particulary in young adults, can lead to acute bronchitis.

Bronchitis risk factors include the following:▪ Air pollutants

▪ Allergies

▪ Chronic sinusitis

▪ Lack of pertussis immunization

▪ Malnutrition (particularly in children)

▪ Exposure to chemicals, fumes, and dust

Smoke inhalation

Bronchitis Signs and SymptomsThe first sign of bronchitis is usually a persistent dry cough (associated with an upper respiratory infection).

Eventually, coughing brings up sputum from the lungs that may be thin, clear, and white. As infection progresses, the sputum becomes thick and yellow, green, or brown.

A thick, pus-filled discharge suggests a bacterial infection.

Other symptoms include the following:▪ Burning pain, wheezing, and crackling in the chest

▪ Painful and difficult breathing

▪ Malaise (generally feeling unwell)

▪ Low-grade fever (101ºF–102ºF)

▪ Insomnia can develop with persistent nighttime coughing. Symptoms usually last 3 to 7 days; a dry cough commonly persists several weeks after the infection resolves.

Complications of BronchitisLeft untreated, acute bronchitis can occasionally progress to pneumonia and chronic bronchitis, particularly in people with suppressed immune systems or lung disease. Chronic bronchitis is associated with long-term constriction of airways, bacterial infection, and other diseases, including asthma, emphysema, and chronic obstructive pulmonary disease (COPD).

Bronchitis DiagnosisDiagnosis is made by the health care provider taking a careful history of symptoms and performing a physical examination. A stethoscope is used to listen to the lungs. If symptoms are prolonged or severe, a chest x-ray may be performed to check for a more serious condition.

Treatment for BronchitisViral bronchitis

Usually resolves without treatment. Increasing fluid intake helps reduce congestion and is necessary when fever is present. Rest is also helpful, and fever and back and muscle pain may be treated with acetaminophen Over-the-counter cough suppressants and expectorants and steamy showers can temporarily relieve symptoms by thinning mucus and opening airways, allowing for easier expulsion of mucus.Bacterial bronchitis

is treated with antibiotics, such as tetracycline, erythromycin, and amoxicillin (in children), depending on the causative bacteria. Side effects of these medications are usually mild and include nausea, vomiting, diarrhea, and abdominal pain.

DRUG: Gemiflaoxacinmesylate has been approved by the Food and Drug Administration (FDA) to treat drug-resistant bacterial bronchitis. This antibiotic medication, which is taken orally in tablet form, is administered once daily for 5 days.Side effects include diarrhea, rash, and nausea.

Prevention of BronchitisGood hygiene can reduce the spread of viral infection. Immunizations against influenza and pertussis can reduce the risk for bacterial bronchitis.Avoiding smoking cigarettes, second-hand smoke, and heavy fumes can hasten recovery, because the lungs' task of filtering pollutants is made easier.

Gastroenteritis▪ Have no energy.▪ Act fussy or cranky.▪ Be less hungry than usual.Some children have more serious symptoms, like wheezing. Call your doctor if your child is wheezing or having trouble breathing.

RSV

How is RSV diagnosed?Doctors usually diagnose RSV by asking about your or your child's symptoms and by knowing whether there is an outbreak of the infection in your area.There are tests for RSV, but they aren't usually needed. Your doctor may want to do testing if you or your child may be likely to have other problems. The most common test uses a sample of the drainage from your nose.

How is it treated?RSV usually goes away on its own. For most people, home treatment is all that is needed. If your child has RSV:

Prop up your child's head to make it easier to breathe and sleep.Suction your baby's nose if he or she can't breathe well enough to eat or sleep.

Control fever with acetaminophen or ibuprofen. Never give aspirin to someone younger than 20 years, because it can cause Reye syndrome.When a person with RSV is otherwise healthy, symptoms usually get better in a week or two.

RSV can be serious when the symptoms are very bad or when it leads to other problems, like pneumonia. Certain people are more likely to have problems with RSV:

Babies younger than 6 months, especially those born early (prematurely)People with immune system problemsPeople with heart or lung problems

Adults older than 65These people sometimes need treatment in a hospital. So it's important to watch the symptoms and call your doctor if they get worse.

HIV

What is HIV? What is AIDS? HIV (human immunodeficiency virus) is a virus that attacks the

immune system, the body?s natural defense system.

Without a strong immune/system , the body has trouble fighting off disease. Both the virus and the infection it causes are called HIV.

White blood cells are an important part of the immune system. HIV invades and destroys certain white blood cells called CD4+ cells. If too many CD4+ cells are destroyed, the body can no longer defend itself against infection.

The last stage of HIV infection is AIDS (acquired immunodeficiency syndrome). People with AIDS have a low number of CD4+ cells and get infections or cancers that rarely occur in healthy people. These can be deadly but having HIV does not mean you have AIDS.

Even without treatment, it takes a long time for HIV to progress to AIDS-usually 10 to 12 years.

If HIV is diagnosed before it becomes AIDS, medicines can slow or stop the damage to the immune system. With treatment, many people with HIV are able to live long and active lives

What causes HIV? HIV infection is caused by the human immunodeficiency virus. You

can get HIV from contact with infected blood, semen, or vaginal fluids.

Most people get the virus by having unprotected sex with someone who has HIV.

Another common way of getting the virus is by sharing drug needles with someone who is infected with HIV.

The virus can also be passed from a mother to her baby during pregnancy, birth, or breast-feeding.

HIV doesn't survive well outside the body. So it cannot be spread by casual contact such as kissing or sharing drinking glasses with an infected person.

Symptoms? IV may not cause symptoms early on. People who do have

symptoms may mistake them for the flu or mono. Common early symptoms include:

Fever.Sore throat.Headache.Muscle aches and joint pain.Swollen glands (swollen lymph nodes).Skin rash.Symptoms may appear from a few days to several weeks after a person is first infected. The early symptoms usually go away within 2 to 3 weeks.After the early symptoms go away, an infected person may not have symptoms again for many years. Without treatment, the virus continues to grow in the body and attack the immune system. After a certain point, symptoms reappear and then remain. These symptoms usually include:

Swollen lymph nodes.Extreme tiredness.Weight loss.Fever.Night sweats.A doctor may suspect HIV if these symptoms last and no other cause can be found.Treatment usually keeps the virus under control and helps the immune system stay healthy.

How is HIV diagnosed?The U.S. Food and Drug Administration (FDA) has approved tests that detect HIV antibodies in urine, fluid from the mouth (oral fluid), or blood. If a test on urine or oral fluid shows that you are infected with HIV, you will probably need a blood test

to confirm the results.If you have been exposed to HIV, your immune system will make antibodies to try to destroy the virus. Blood tests can find these antibodies in your blood

References http//www.coldflu.about.comhttp//www.ncbi.nim.govhttp//www.drmyhill.co.uk/viral infectionhttp//www.webmd.com/cold-fluhttp//www.nativeremeidies.com/aliment/infectionhttp//www.nerckmanuals.com/…/infectionjosephdipiro .

THANK YOU