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22 Cards in this Set
- Front
- Back
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Acyclovir (ACV)
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- Active against HSV, VZV
- Guanosine analog (competitive inhibitor of viral DNA polymerase) - Must be phosphorylated by viral thymidine kinases - Oral, IV, and topical admin - Uses: genital herpes, prophylaxis in immunosuppressed pts, IV for HSV encephalitis - Toxicity: GI, headache, renal, neurologic; bone marrow suppression w/ long-term, high-dose use |
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Ganciclovir
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- Analog of acyclovir with 8 to 20X greater activity against CMV
- IV, oral, or intraocular admin - Toxicity: neutropenia; don’t give to pregnant women |
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Valganciclovir
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- Prodrug of ganciclovir—used to treat CMV
- Oral admin |
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Valacyclovir
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- Converted in vivo to acyclovir
- Use in HSV-infected pt to reduce risk of transmission to susceptible partner |
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Trifluridine
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- Used to treat HSV keratitis
- Nucleoside analog - Topical admin |
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Idoxuridine
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- Used to treat HSV keratitis
- Nucleoside analog - Topical admin |
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Cidofovir
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- Nucleotide analog
- IV, intravitreal, and topical admin - Used to treat CMV retinitis in AIDS pts - Toxicity: renal (give with probenecid) |
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Foscarnet
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- Phosphonoformate (reversible inhibitor of viral DNA and RNA polymerase)
- IV admin - Uses: CMV retinitis in immunocompromised pts, acyclovir-resistant HSV - Toxicity: renal, anemia, nausea, fever |
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Formivirsen
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- Used to treat CMV retinitis
- Antisense oligo-NT—binds to CMV mRNA - Intraocular admin |
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Amantadine
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- Active against influenza A only
- Interferes with function of viral M2 protein --> no viral uncoating - Oral admin; give <48 hrs after onset of symptoms - Renal excretion - Toxicity: neurologic, GI; don’t give to pregnant/nursing women |
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Rimantadine
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- Same as amantadine but with less neurotoxicity
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Zanamivir
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- Active against influenza A and B
- Neuraminidase inhibitor - Inhalation or intranasal admin - Used for prophylaxis or treatment (give <72 hours after onset of symptoms); works better than oseltamivir - Toxicity: exacerbation of reactive airway disease |
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Oseltamivir
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- Same as zanamivir, but with oral admin
- Toxicity: nausea, vomiting |
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Ribavirin
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- Inhibits nucleoside biosynthesis, mRNA capping, and other processes (cellular and viral) impt for the replication of many viruses
- Aerosol and oral admin - Hepatic metabolism, renal excretion - Uses: oral for tx of HCV (in combo with IFN-α), aerosol for tx of RSV in kids, also for severe influenza resistant to other agents - Toxicity: anemia; don’t give to pregnant women |
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Lamivudine (3TC)
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- NRTI used to treat HBV (originally an anti-HIV drug)
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Adefovir
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- NRTI used to treat HBV (originally an anti-HIV drug)
- Active against lamivudine-resistant HBV - Toxicity: renal (at high doses) |
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Entecavir
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- NRTI used to treat HBV, HIV
- Active against lamivudine-resistant HBV |
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Telbivudine
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- Synthetic thymidine analog active against HBV
- No activity against HIV |
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Interferons
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- Induce an antiviral state within cells
- Binding to cell surface receptors --> JAK/STAT pathway activation --> cleavage of single-stranded mRNA, inhibition of protein synthesis, inhibition of viral transcriptases, induction of nitric oxide - IFN-α and -β have more anti-viral activity; IFN-γ has more immunomodulatory activity - Parenteral admin (IM or SC) - Uses: HCV (use “pegylated” IFN-α in combo with ribavirin), condyloma acuminata - Toxicity: flu-like symptoms, bone marrow suppression, neuropsychiatric (don’t use in suicidal pts) |
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Passive immunization (IVIG)
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- Available for prevention/tx of hep A and B, enteroviruses, B19 parvovirus, CMV, rabies, RSV, VZV, vaccinia
- Intravenous immunoglobulin (IVIG) helpful for some viral infx |
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VariZIG
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Passive immunization for VZV
- Contains very high titers of ab to VZV - Only useful when given to a varicella susceptible; will prevent zoster - Must be given as soon as possible after exposure in order to work |
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Palivizumab
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- Humanized RSV monoclonal ab
- Used to prevent complications of RSV infection in young children |
