Antifungal And Antiviral Agents: Antivirals

Front 1

Antiviral Agents include:
a.
b.
c.
d.
e.
f.

Back 1

Antiviral Agents include:
a. Acyclovir
b. Famciclovir
c. Valacyclovir
d. Ganciclovir
e. Foscarnet
f. Cidofovir

Front 2

Acyclovir
method of action:

Back 2

Acyclovir
method of action: Inhibits viral DNA synthesis; toxic to cells infected with virus, but not to normal host cells
*Spectrum: active against Herpes simplex virus (HSV) types I and II (genital), herpes zoster, varicella

Front 3

Acyclovir
pharmacotherapy:

Back 3

Acyclovir
pharmacotherapy:
a. Topical
b. Oral
c. IV

Front 4

Acyclovir
safety profile:

Back 4

Acyclovir
safety profile:
a. headache, dizziness
b. local irritation with topical preparatoin, IV site
c. n/v/d
d. nephrotoxicity: IV form, if given over less than 10 minutes or with inadequate hydration

Front 5

Famciclovir
method of action:

Back 5

Famciclovir
method of action: Prodrug that is biotransformed into active compound PENCICLOVIR which inhibits viral DNA synthesis
*Spectrum: Herpes virus I and II and varicella zoster

Front 6

Famciclovir
safety profile:

Back 6

Famciclovir
safety profile:
*carcinogenic in rats; impaired fertility in male animals

Front 7

Valacyclovir
method of action:

Back 7

Valacyclovir
method of action: prodrug that is biotransformed to acyclovir
*Spectrum: see acyclovir- active against Herpes simplex virus (HSV) types I and II (genital), herpes zoster, varicella

Front 8

Ganciclovir
method of action:

Back 8

Ganciclovir
method of action: inhibits viral DNA replication
*Spectrum: Active against herpes viruses, including CYTOMEGALOVIRUS (CMV)

Front 9

Ganciclovir
pharmacotherapy:

Back 9

Ganciclovir
pharmacotherapy:
a. Treatment of CMV infections, including retinitis in AIDS
b. Prevention of CMV disease in transplant recipients

Front 10

Ganciclovir
safetey profile:

Back 10

Ganciclovir
safetey profile:
a. HEMATOPOIETIC: granulocytopenia (40%), thrombocytopenia (20%), anemia (2%)
b. Pain, phlebitis at injection site
c. Elevated liver function tests
d. CARCINOGENESIS: demonstrated in mice, potentially carcinogenic in humans
e. Drug interactions - zidovudine, amphotericin B. antineoplastics, flucytosine - increased bone marrow suppression

Front 11

Ganciclovir
Valganciclovir (Valcyte)info:

Back 11

Ganciclovir
Valganciclovir (Valcyte)info: new tablet option for oral therapy
*PRODRUG OF GANCICLOVIR- metabolized in the liver to ganciclovir
*oral bioavailability of valganciclovir far exceeds that of oral ganciclovir- achieves levels similar to IV dosing
*can be used for induction AND maintenance therapy

Front 12

Foscarnet
method of action:

Back 12

Foscarnet
method of action: Inhibits viral replication by binding to DNA polymerases and reverse transcriptase

Front 13

Foscarnet
pharmacokinetics:

Back 13

Foscarnet
pharmacokinetics:
a. deposits in bone
b. eliminated renally

Front 14

Foscarnet
pharmacotherapy:

Back 14

Foscarnet
pharmacotherapy:
a. Treatment of CMV disease, including retinitis in AIDS
b. Active against other herpes viruses, including ACYCLOVIR-RESISTANT strains

Front 15

Cidofovir
method of action:

Back 15

Cidofovir
method of action: inhibits viral DNA replication

Front 16

Cidofovir
pharmacokinetics:

Back 16

Cidofovir
pharmacokinetics:
a. long intracellular half-life allows biweekly dosing
b. renally excreted

Front 17

Cidofovir
pharmacotherapy:

Back 17

Cidofovir
pharmacotherapy: management of CMV retinitis

Front 18

Cidofovir
safety profile:

Back 18

Cidofovir
safety profile:
a. Nephrotoxicity common: prehydration and coadministration of probenicid protects kidney
b. Myelosuppression (leukopenia most common)