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The patient required a flexible nasopharyngolaryngoscopy by a head and neck surgeon, which revealed mild edema and erythema of the epiglottis and the arytenoids

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And anyway, isnt smoking way down? But take a look at the figures and youll see the reality is not so rosy

32-34 Newer Drugs Newer oral agents such as valacyclovir (Valtrex, GlaxoSmithKline, Philadelphia, PA), which is the prodrug to acyclovir, and famciclovir (Famvir, Novartis, East Hanover, NJ), which is the prodrug to penciclovir (Denavir, Prestium Pharma, Newtown, PA), have increased bioavailability relative to oral acyclovir and have produced systemic concentrations nearly equal to those obtained with intravenous acyclovir, 35 achieving systemic levels greater than the in vitro 50% inhibitory concentrations of VZV, HSV-1 and HSV-2