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44 Cards in this Set
- Front
- Back
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What limits the MOA for antiviral drugs?
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The virus using the host cell's metabolic pathways for reproduction
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Do antibiotics/antifungals have any effect on viruses?
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NO
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What are most antivirals? What do they do?
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Antimetabolites of endogenous nucleosides. Prevent replication of viral nucleic acid.
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What is easier to treat, an early term virus or a late term virus?
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EARLY
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What kind of viruses are HSVs?
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DNA
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What does the Varicella-zoster virus cause?
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chickenpox (varicella) or shingles (herpes zoster)
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Who is affected by the cytomegalovirus?
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immunocompromised
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What type of drugs are used for HSV infections?
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NUCLEOSIDE ANALOGS (prodrugs)
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What is a prodrug?
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Drugs which are converted into the active form in the infected host cell.
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Will viral resistance develop against prodrugs?
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YES. Varies with drug and viral pathogen.
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Acyclovir (Zovirax)
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PO, IV, top. Class B.
Inhibits viral replication. Does not cure. Shortens duration and alleviates symptoms. May prevent recurrence. |
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What are the ADRs of acyclovir?
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itching, hives, nephrotoxic, N/V/D, headache, paresthesias
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Does the PO form of Acyclovir have good bioavailability?
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NO
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When should you use the IV form of Acyclovir?
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Serious or systemic infections
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When should you prescribe the topical form of Acyclovir?
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Genital herpes
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What are the two newest types of antivirals used to treat HSV?
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Valacyclovir, Famciclovir
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What makes valacyclovir and famciclovir better than acyclovir?
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Increased bioavailability, less dosing (2 x daily). More effective against shingles.
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What are the ADRs of valacyclovir and famciclovir?
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headache, NVD, fatigue. (Less than acyclovir)
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When can you use penciclovir?
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(Denavir) Topical for herpes labialis.
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When can you use Docosanol?
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(Abreva) Topical for herpes labialis. LIMITED INFO AVAILABLE. * NOT NUCLEOSIDE ANALOG
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What are the ADRs of docosanol and penciclovir?
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local irritation, erythema, headache
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New Varicella-Zoster Vaccine
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Vaccine for shingles. Pts 60+ only. Live VZV. More potent than chickenpox vacc. Redux # cases, cases milder. Redux in likelyhood of getting postherpetic neuralgia.
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Treatments for HSV occular infx
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Vidarabine (oint), trifluridine (sol). Both Class C. Both used to treat keratoconjunctivitis and recurrent epithelial keratitis. ADR = local effects. Possible absorption.
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Treatment of CMV
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Ganciclovir. Class C. PO/IV/implant. Treats CMV retinitis, prevention of CMV disease in HIV/transplant pts. PO = low F. ADRs = bms, h/a, confusion, retinal detatchment, liver/renal dys, rash, fever, GI fx.
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What is different about Ganciclovir?
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Can cause cell mutation. Not category X, but pregnant women should not handle the drug.
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Valganciclovir
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Same indication as Ganciclovir. Prodrug. Dose = less frequent. PO. Class C.
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Cidofovir
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IV. Class C. Same indications as Ganciclovir. Reserved for resistant viruses. Higher incidence of more serious ADRs.
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Foscarnet
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NOT NUCLEOSIDE ANALOG. IV. Class C. Use to treat CMV when Ganciclovir fails. Lots of ADRs. Used in resistant HSV infx.
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What are the two possible antivirals for occular CMV?
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Ganciclovir (implant), Fomiversin (injection)
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What is the optimal time to immunize for the flu?
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October through December
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Influenza Virus Vaccine
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Provide active immunity to strains in the vaccine. Contains A and B. IM inj. Inactivated. DOES NOT CAUSE FLU.
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What kind of allergy would prevent a pt from getting the normal IM seasonal flu vaccine?
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Egg
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Flumist
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Nasal flu vaccine. LIVE. About as effective as IM inj. Approved for pts 2- 49. Not approved for pts 50+ or w/ chronic illness. $$$$
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Drugs for Influenza A
(Amantadine, Rimantadine |
MOA: inhibts A replication only. Blocks viral membrane matrix protein (M2). Used for prophylaxis. Redux symptoms/ shorten duration.
PO, Class C |
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Drugs for Influenza A and B
(Tamiflu, Relenza) |
Indication: treatment & prevention of seasonal flu and H1N1.
Tamiflu = 1yr+, PO, C Relenza = 7yr+, INH, B MOA = block neuraminidase. Decrease onset of symptoms, shorten duraiton if taken 24-48 hrs after onset. |
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Ribavirin
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INH, Class X. For severe LRI due to RSV. Redux duration, take off ventilator sooner, improves arterial O2. MOA = prevents mRNA capping and blocks RNA pol. ADRs = serious pulmon/cardiovasc fx.
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Palivizumab
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IM, C. Recombinant drug. PREVENTION of LRI due to RSV. ADRs = nervousness, fever, fungal dermatitis, eczema, NVD, anemia, otitis media, cogh, wheeze.
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Interferons
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*Therapeutic option. Recombinant DNA tech w/immunomodulating and antiproliferative fx. 3 forms. Tx for hep B/C, cancers, anogential warts. Important ADRs = myalgia, fatigue.
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Ribiviran
(Rebetol, Copegus) |
PO. X. Given with interferon alpha 2b (for hep C pts w/ LD). ADRs = CNS side fx, alopecia, rash, pruitis, GI, BMS, NOT FDA approved to Tx west nile, hemorrhagic fever virus, etc.
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Nucleotides for Hep B Infx
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Lamivudine, Adefovir, Entecavir, Telbivudine
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HPV IM Vaccine
(Gardasil) |
Indicated to prevent disease caused by HPV types 6, 11, 16, 18. 3 doses (0, 2, 6 mos). Women ages 9-26.
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Rotavirus Vaccine
(RotaTeq) |
Live oral vaccine for rotavirus. MC cause of diarrhea/vomiting in young children. Given to infants 2, 4, 6 mos. Reports of intususseption.
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Avian Flu Vaccine
(H5N1) |
Not available commercially. Rsvd for outbreak. MAY provide protection in event of pandemic. (Bird flu)
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Swine Flu Vaccine
(H1N1) |
Currently in production. Possibly ready for fall. Given with seasonal flu vaccine. 2 shots. Young people 1st.
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