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Posts Tagged ‘Shingles’

Shingles and Shingrix – What is it, and how can we prevent it? By Our Student Pharmacist, Madeline VanLoon.

What is “shingles”?

Shingles (herpes zoster) usually refers to an infection caused by the varicella zoster virus (VZV). It is the same virus responsible for chickenpox (varicella). Shingles typically manifests as a painful rash that forms where nerves from the spinal cord connect with the skin. This area is called a dermatome. The rash appears along a dermatome located on one side of the body. It is red, blistering, and can last up to thirty days. The pain associated with the rash is commonly described as “a deep burning,” “throbbing,” or “stabbing” sensation. Dermatomes are considered contagious until they dry and crust over (about 7 to 10 days after first symptoms appear). Scarring and changes in skin color at the lesion sites may occur.

Shingles - Mayo Clinic

The most common complication of shingles is postherpetic neuralgia (PHN), a condition characterized by persistent numbness, itching, and pain. This condition affects 10-15% of shingles patients and is defined by significant pain lasting for 90 days after onset of rash.

Are you at risk?

immune response after shingrix - Shingrix website

If you have had chickenpox, the virus that causes shingles is inside your body and can reactivate.

  • 99% of people over the age of 50 are living with the virus that causes shingles.

  • There are 1.2 million cases annually in the United States.

  • The risk is greatest in those whose immune system is weaker.

  • 1 in 3 people will get shingles in their lifetime, and your chances increase as you age.

  • 1 in 4 people will have a complication related to shingles. This could mean long term nerve pain, lasting months or even years after the rash has healed.

How do we treat shingles?

Shingles is treated with antiviral medications to enhance healing of skin lesions and decrease the severity of nerve pain. It is recommended to administer antiviral medications within 72 hours of the onset of symptoms for the most benefit. Pain relievers such as acetaminophen and NSAIDs (ibuprofen, naproxen) are used to manage mild to moderate pain. Other medications may be considered for treating associated skin infections and nerve pain in extreme cases.

 

Web MD Images

How can we prevent shingles?

Fortunately, a vaccine exists to prevent shingles. The vaccine, Shingrix, is a two-dose vaccine series recommended for those over the age of 50, even if they have previously been vaccinated with Zostavax. Shingrix is 90% effective at preventing shingles  – far superior to Zostavax, which has shown to be only 51% effective.

What should I know about the vaccine, Shingrix?

  • Shingrix is NOT a live vaccine. It is a recombinant vaccine with an adjuvant. It works to boost your body’s protection against shingles.

  • Complete vaccination with Shingrix requires two doses.The second dose should be received 2 to 6 months after the first dose. This is important to prevent shingles.

  • It is administered into the muscle of the upper arm.

  • Common side effects include pain, redness, swelling at the injection site, muscle pain, tiredness, headache, and flu-like symptoms. These effects should be temporary, and certainly far less severe than shingles itself.

What if I am immunocompromised ?

Being immunocompromised refers to having an immune system that is not working as well as it should as a result of advanced age, taking certain medications like steroids or chemotherapy, or other conditions such as HIV/AIDS. Low levels of immune system suppression are generally acceptable, but not all conditions have been evaluated by the Centers for Disease Control and Prevention (CDC) yet. Talk to your pharmacist to see if Shingrix is appropriate for you.

References:

Epidemiology, clinical manifestations, and diagnosis of herpes zoster. UpToDate. Wolters Kluwer. Available at https://www.uptodate.com. Accessed June 4, 2020.

Answer questions about the new shingles vaccine Shingrix. Pharmacist’s Letter: 2018.https://pharmacist.therapeuticresearch.com. Accessed June 4, 2020.

Shingles Vaccine: FAQs. Pharmacist’s Letter. 2018. https://pharmacist.therapeuticresearch.com. Accessed June 4, 2020.

Shingrix (Zoster Vaccine Recombinant, Adjuvanted). GSK. https://www.shingrix.com/index.html. Published 2018. Accessed June 4, 2020.

Vaccination for the prevention of shingles (herpes zoster). UpToDate. Wolters Kluwer. Available athttps://www.uptodate.com. Accessed June 4, 2020.

What everyone should know about Zostavax. CDC. 2018.https://www.cdc.gov/vaccines/vpd/shingles/public/zostavax/. Accessed June 4, 2020.

 

Images:

  1. https://www.mayoclinic.org/diseases-conditions/shingles/symptoms-causes/syc-20353054#dialogId45719376

  2. https://www.shingrix.com/discover-shingrix.html

  3. https://www.webmd.com/skin-problems-and-treatments/shingles/ss/slideshow-shingles-pictures

Shingles Prevention. By Our August Student Pharmacist, Joshua Kretzer.

Chicken pox affected many of us when we were children resulting in a rash and sores covering the head, arms, and body. The varicella-zoster virus (VZV) is a highly contagious virus that causes the chicken pox infection. VZV typically infects children under 15 years of age. However, VZV can also affect adults.

Once you have been infected with the virus, it remains inactive in your body’s nervous system for life. After infection, it is unlikely you will develop chicken pox a second time. You are, however, at risk of developing shingles.

Shingles can be a very painful condition commonly resulting in a rash on the back that continues around to the stomach. The rash often appears in line patterns on one side of the body.

Other symptoms that potentially occur include:

  • Burning
  • Shooting pain
  • Tingling
  • Itching
  • Blisters
  • Fever/chills
  • Headache
  • Joint pain
  • Swollen glands

The rash is not limited to the body but can occur on the arms, legs, and face, as well. When the face is affected multiple other symptoms can develop including:

  • Difficulty moving muscles in the face
  • Drooping eye lid
  • Hearing loss
  • Loss of eye motion
  • Taste problems
  • Vision problems

The pain associated with shingles can range from mild to severe and can last from weeks to years after the blisters have healed.

Shingles occurs due to re-activation of VZV from the nervous system. It is unknown why the virus becomes re-activated.

Certain people are at a greater risk of developing shingles including:

  • People older than 50 years old.
  • People who had chickenpox before 1 year of age.
  • People who have weakened immune systems.
  • People who take medications that weaken the immune system.

Shingles does not only occur in the elderly. Everyone is at risk of developing shingles. You are just at a greater risk of developing shingles as you get older.

Shingles cannot be passed from one person to another. The virus can, however, still be passed to someone who has not been exposed to the virus. Therefore, if you have shingles avoid contact with anyone who has not had chicken pox or the vaccine against chicken pox (young or old–adults can get chicken pox too!).

Unfortunately, there is no cure for shingles. We can, however, prevent shingles through vaccination. Zostavax (also known as the shingles vaccine) is our main line of defense against shingles. By receiving Zostavax, you are able to reduce your risk of developing shingles by up to 50%!

There are still some people who get shingles even after vaccination. Those that do get vaccinated, however, have much milder symptoms than those who don’t receive the vaccine.

Zostavax can be given starting at the age of 50 and is recommended in everyone 60 years and older. Zostavax is a one-time vaccine that can be administered by any pharmacist!

And did I mention that you no longer need a prescription to receive Zostavax?  That’s right! No prescription needed! So stop in anytime and see us. We would be glad to discuss any questions or concerns you may have and then get you vaccinated!

Remember, prevention is the best medicine!

What Everyone Should Know About Shingles. By Our August Pharmacy Student, Basil Sarantis.

If you have had chicken pox before (or even if you haven’t), please read!

Hello, everyone! My name is Basil Sarantis and I am a pharmacy student who will be here at Plain City Druggist for the month of August.  Throughout the month, I will be writing some short blog posts on topics of my choice. With that being said, my first question to my new readers is, have you had chicken pox at any point in your life?  If you have, then continue reading. If you have not, continue reading anyway and tell your friends and family about this blog (because they may have had chicken pox before).

So why am I asking about chicken pox? People who have had chicken pox before usually had the virus at a young age. Those suffering from chicken pox were miserable and itchy for about a week, and then they recovered. The thing is, the virus that causes chicken pox, called varicella-zoster, is still in those people’s bodies, and will be forever, even though they may have no signs of chicken pox. Years to decades later, the same virus that causes chicken pox can cause shingles.

Shingles, also known as herpes zoster, is a skin rash that often is associated with blisters. Some other symptoms are pain, tingling, or numbness. The most serious long-term effect of shingles is something called post-herpetic neuralgia or PHN–simply put, severe nerve pain. This condition can last long after the rash caused by shingles disappears, and it can be extremely difficult to treat, greatly affecting a person’s quality of life. Also, shingles is more likely to appear in people aged 50 or older, and is even more likely in patients who have a weakened immune system due to medications, cancer, or infections.

So what can you do to help prevent shingles? The answer is simple. Talk with your doctor about the shingles vaccine and see if it would be a reasonable option for you.  The CDC (Centers for Disease Control and Prevention) recommends the shingles vaccine for people 60 and older.  The shingles vaccine has been proven to reduce the risk of developing shingles by about 50%. Those who did develop shingles even with having received the vaccine, experienced a more mild form of the disease and had much less pain, both short term and long term.

Unlike some vaccinations (like the flu-shot–which everyone should be getting this fall in time for flu season), the shingles vaccine requires a prescription from your doctor. The vaccine can then be given at almost any pharmacy–like right here at Plain City Druggist!

So in summary, if you have ever had the chicken pox (or even if you haven’t), and you are 50 or older, talk with your doctor about the shingles vaccine. One conversation can prevent a lot of unnecessary pain and frustration for you and your family in the future.  Remember, prevention is the best medicine.

Thanks for reading.

Source: www.nfid.org (National Foundation for Infectious Diseases)

To see a slideshow on Shingles on WebMD, go HERE.

 

 

Zostavax Vaccine for Shingles. By Pharmacy Intern John Bishel (You Can Call Him J. B.).

Hello, everyone. This is John Bishel, the intern at Plain City Druggist for the month of March, writing this blog posting. If you have not met me, I am currently in my last year of pharmacy school at Ohio State (Go, Buckeyes!) and I have been helping Joe around the pharmacy. I have the opportunity of reaching out to you to talk about the shingles vaccine with this post.

What is shingles?

Shingles is a painful, blistering skin rash due to a virus called varicella-zoster, the same virus that causes chickenpox.  Shingles occurs when the chickenpox virus reactivates.

What is in the shingles vaccine?

The shingles vaccine known as Zostavax® contains a weakened form of the chickenpox virus. The vaccine can help prevent you from getting shingles. As with all things in medicine, the vaccine is not 100% effective, but is recommended by the Centers for Disease Control (CDC) to help prevent shingles in patients 60 years of age and older who have a history of chickenpox.

Who is recommended to get the shingles vaccine?

The Center for Disease Control (CDC) recommends that patients with a history of chickenpox (about 9 out of 10 of us) and older than 60 years old receive the Zostavax® vaccine. Zostavax® is not recommended, though, in patients who are currently immunosuppressed, taking immunosuppressive medications such as steroids, pregnant, allergic to gelatin or neomycin (an old antibiotic commonly found in Neosporin®), or allergic to any ingredient in the vaccine. Feel free to ask Joe, Robin, or any of the pharmacists if they believe the vaccine is right for you.

Do I need a prescription from my doctor?

In the state of Ohio, a prescription written within the last 30 days from your physician is required to give you the Zostavax® vaccine in the pharmacy.

Why do pharmacists administer the vaccine?

Because of the cost of the vaccine (~$225) and the restriction that it be administered within 30 minutes of mixing, many doctors’ offices have refrained from providing the vaccine.

Are there side effects?

About 50% of people experience redness, pain, or swelling around the injection site. Other common reactions include itching, warmth, and headache. Most other reactions are rare and can be discussed with your physician or pharmacist.

How much does it cost and is it covered by my insurance?

That is a great question and we can always process a prescription for you to find out. I would recommend calling your insurance company’s 800 number to ask them to estimate the cost for you. Zostavax® is covered for most patients over 60 years old and for those covered by Medicare Part D.

Please feel free to ask any questions that you think of to the wonderful pharmacists at Plain City Druggist. Also ask your doctor at your next visit if they think Zostavax® is right for you.

To read more about shingles or the vaccine please visit these websites:

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001861/

http://www.merck.com/product/usa/pi_circulars/z/zostavax/zostavax_ppi.pdf