Acquired immunodeficiency syndrome

aids.

acyclovir (Zovirax) An antiviral drug introduced in 1982 that is used to treat viruses causing chicken pox, shingles, or herpes simplex infection. It is officially approved for the acute management of chicken pox in children, for which it can slightly decrease the severity and duration of the infection. To be effective, therapy must be started within 24 hours of the onset of the rash. Its effect on the subsequent development of shingles is not known

When acyclovir is given in time, it decreases itching, the number of lesions, and the time until crusting. By the third day, all treated children, compared to 75 percent of untreated children, have no fever. Acyclovir does not work if given after the first 24 hours past the start of the rash.

Although acyclovir can decrease the duration and severity of varicella, it should not be given routinely to children who are otherwise healthy. Acy-clovir is not indicated in youngsters under age two.

Currently, no data indicate that treating chicken pox with acyclovir hastens the return of children to school or parents to work; the rate of development of complications has not been diminished by active therapy.

Acyclovir has also been used to prevent the development of chicken pox in families in which one child has developed a rash before others; in one study, acyclovir given to exposed children seven to nine days after exposure for seven days protected 84 percent of children, who did not develop overt symptoms.

The American Academy of Pediatrics recommends against the routine use of acyclovir in cases of uncomplicated chicken pox in otherwise healthy children. The AAP does recommend acy-clovir for susceptible teenagers who are not pregnant, or for those children over 12 months of age who are receiving long-term salicylate therapy because of the risk of Reye's syndrome, in those with chronic pulmonary or skin problems, and in those receiving aerosolized corticosteroids. However, the benefits of therapy in these groups has not been proven.

Side Effects

Adverse effects from acyclovir are uncommon. Taken by mouth, the drug may rarely cause stomach problems, headache, dizziness, or nausea and vomiting. The ointment may cause skin irritation or rash. Very rarely, acyclovir injections may lead to kidney damage.

ADD See attention deficit hyperactivity disorder.

Adderall A stimulant medication prescribed for attention deficit hyperactivity disorder (ADHD) that is a combination of dextramphetamine and amphetamine. Adderall can be used in children over the age of three.

The drug can improve attention span and decrease distractibility, and may decrease impulsiv-ity, stubbornness, and aggression. The drug only needs to be taken once or twice a day; while the effects may be noted immediately, it may take up to six weeks to achieve its full benefit.

Adderall is usually prescribed as part of a treatment plan that includes educational and psychosocial treatment. It is sometimes prescribed in cases in which Ritalin or other stimulant medications have been ineffective. Because it has a fairly slow onset of action, there may be less chance of Adderall causing or worsening tics.

Adderall had earlier been approved and marketed by another company under a different name (Obetrol) as a weight control medication. The manufacturer was taken over by another company, which renamed the product Adderall in 1994. The drug was approved for the treatment of ADHD and reintroduced in 1996 as Adderall.

Side Effects

Most common side effects include appetite and weight loss, insomnia, and headache. Less frequently, a patient may experience dry mouth and nausea. Rare side effects include dizziness, irritability, stomach pain, increased heart rate, or hallucinations. As with most stimulants indicated for ADHD, there is a possibility of growth suppression and the potential for triggering motor tics and tourette's syndrome; in rare cases, worsening of psychosis has been reported.

As with all other stimulants used in treating ADHD, one of the more troublesome side effects is a decrease in brain growth. Although there is something of a rebound effect once the child is removed from the drug, the rebound generally does not bring the child back to the same level on the brain growth charts prior to drug treatment.

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