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9 Cards in this Set
- Front
- Back
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HSV
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- genital herpes infection
- infection of the mouth and lips - anorectal mucocutaneious diseae - esophagus - keratoconjunctivitis - Encephalitis |
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Varicella Zoster Virus
Cytomegalovirus |
- Chicken pox and shingles
- CMV retinitis, colitis, esophagitis, hepatitis, (immunocompromised pt) |
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MOA OF acyclovir:
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- cellular uptake and initial phosphorylation by HSV thymidine kinase
- selective toxicity - the affinity for HSV kinase is 200 fold > than for mammalian enzyme. - competitive inhibition w/ dGTP for the VIRAL DNA. -- as a CHAIN TERMINATOR. |
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Resistance to Acyclovir:
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- 1. Absence or partial production of V tk.
2. Altered thymidine kinase substrate specificity (phosphorylation of thymidine not acyclovir) 3. Altered viral DNA polymerase. CAUSED BY point mutation, base insertions, or deletions. |
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Acyclovir: (wide distribution)
- ROUTE of excretion: |
- Route of excretion: glomerular filtration and tubular secretion.
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Half life of acyclovir with normal kidney vs. anuria.
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normal kidney: 3 hours
anuria: 20 hours. METABOLISM 10-30% |
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Adverse Effect of acyclovir:
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- Nausea, diarrhea, malaise
- Precipitation of crystals in renal tubule. - decreased CrCl - Injection site reactions. - CNS side effects (Altered sensorium, tremor, myoclonus, delirium, seizures, coma) |
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Valacylovir converted to acyclovir:
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- 1st pass intestinal and hepatic metabolism
- increase p.o. bioavailability to 70% |
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Valacyclovir Adverse Effects:
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- thrombotic thrombocytopenic purpura.
- nausea, ha, diarrhea. High Doses: hallucinations, confusions, nephrotoxicity. |
