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Shingles (Pharmacy First)

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sepsis>=1>=1>=1noyes0>=1NOYESYESNOYESNOYESNOYESNONO>=1NOYES000>=1noyes0>=100>=1>=10>=10>=10noyes0>=1>=10>=10>=10
Question

Is the patient suitable for aciclovir (5x daily dosing)?

Question

Check valaciclovir eligibility, Select ALL that apply. If none apply, select "none apply".

Referral

Patient falls under valaciclovir PGD exclusion criteria. Onward referral — General practice or other provider as appropriate.

Question

Check aciclovir eligibility, Select ALL that apply. If none apply, select "none apply".

Question

Concurrent medication for aciclovir. Select ALL that apply. If none apply, select "none apply".

Referral

Patient falls under aciclovir PGD exclusion criteria. Onward referral — General practice or other provider as appropriate.

Referral

Patient falls under aciclovir PGD exclusion criteria. Onward referral — General practice or other provider as appropriate.

Outcome

Offer aciclovir plus self care. Aciclovir 800mg five times daily (4-hourly during waking hours) for 7 days. Or if unsuitable: offer valaciclovir (subject to inclusion/exclusion criteria in PGD) plus self care.

Question

Concurrent medication for valaciclovir. Select ALL that apply. If none apply, select "none apply".

Info

Shingles (Herpes Zoster) For adults aged 18 years and over. Exclude: pregnant individuals.

Question

Is the patient eligible for the Shingles pathway? Select ANY that apply.

Referral

Patient is not eligible for this pathway. Refer to GP or appropriate service.

Referral

Urgent: call 999 or signpost patient to A&E immediately. Consider calculating NEWS2 Score ahead of signposting patient to A&E or calling 999 in a life-threatening emergency.

Outcome

Shingles less likely. Consider alternative diagnosis and proceed appropriately.

Question

Does the patient have shingles within 72 hours of rash onset?

Question

Does the patient meet any of the following criteria? Select ANY that apply.

Question

Does the patient have shingles up to one week after rash onset?

Question

Does the patient meet any of the following criteria? Select ANY that apply

Question

Does the patient follow typical progression of shingles clinical features? (Click on info button for guide)

Outcome

Patient does not meet treatment criteria. Share self-care and safety-netting advice.

Outcome

Patient does not meet treatment criteria. Share self-care and safety-netting advice.

Question

Is the patient suitable for aciclovir (5x daily dosing)?

Question

Does the patient have shingles up to one week after rash onset?

Question

Does the patient meet any of the following criteria? Select ANY that apply

Outcome

Patient does not meet treatment criteria. Share self-care and safety-netting advice.

Outcome

Patient does not meet treatment criteria. Share self-care and safety-netting advice.

Outcome

Offer valaciclovir 1g three times daily for 7 days plus self care. Preferred for: • Immunosuppressed patients • Adherence risk: already taking 8 or more medicines a day or is assisted in taking their medicines Press info button for advice for immunosuppressed patients.

Question

Consider the risk of deterioration or serious illness. Select ANY that apply.

Referral

Patient falls under valaciclovir PGD exclusion criteria. Onward referral — General practice or other provider as appropriate.

Question

Check aciclovir eligibility, Select ALL that apply. If none apply, select "none apply".

Referral

Urgent A&E referral via ambulance for sepsis

Question

Check valaciclovir eligibility, Select ALL that apply. If none apply, select "none apply".

Referral

Patient falls under valaciclovir PGD exclusion criteria. Onward referral — General practice or other provider as appropriate.

Question

Concurrent medication for aciclovir. Select ALL that apply. If none apply, select "none apply".

Referral

Patient falls under aciclovir PGD exclusion criteria. Onward referral — General practice or other provider as appropriate.

Referral

Patient falls under aciclovir PGD exclusion criteria. Onward referral — General practice or other provider as appropriate.

Outcome

Offer aciclovir plus self care. Aciclovir 800mg five times daily (4-hourly during waking hours) for 7 days. Or if unsuitable: offer valaciclovir (subject to inclusion/exclusion criteria in PGD) plus self care.

Outcome

Offer valaciclovir 1g three times daily for 7 days plus self care. Preferred for: • Immunosuppressed patients • Adherence risk: already taking 8 or more medicines a day or is assisted in taking their medicines Press info button for advice for immunosuppressed patients.

Question

Concurrent medication for valaciclovir. Select ALL that apply. If none apply, select "none apply".

Referral

Patient falls under valaciclovir PGD exclusion criteria. Onward referral — General practice or other provider as appropriate.

Question

Check valaciclovir eligibility, Select ALL that apply. If none apply, select "none apply".

Question

Check aciclovir eligibility, Select ALL that apply. If none apply, select "none apply".

Question

Concurrent medication for aciclovir. Select ALL that apply. If none apply, select "none apply".

Referral

Patient falls under aciclovir PGD exclusion criteria. Onward referral — General practice or other provider as appropriate.

Referral

Patient falls under aciclovir PGD exclusion criteria. Onward referral — General practice or other provider as appropriate.

Outcome

Offer aciclovir plus self care. Aciclovir 800mg five times daily (4-hourly during waking hours) for 7 days. Or if unsuitable: offer valaciclovir (subject to inclusion/exclusion criteria in PGD) plus self care.

Referral

Patient falls under valaciclovir PGD exclusion criteria. Onward referral — General practice or other provider as appropriate.

Outcome

Offer valaciclovir 1g three times daily for 7 days plus self care. Preferred for: • Immunosuppressed patients • Adherence risk: already taking 8 or more medicines a day or is assisted in taking their medicines Press info button for advice for immunosuppressed patients.

Question

Concurrent medication for valaciclovir. Select ALL that apply. If none apply, select "none apply".

Referral

Patient falls under valaciclovir PGD exclusion criteria. Onward referral — General practice or other provider as appropriate.

Question

Is the patient suitable for aciclovir (5x daily dosing)?

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