Herpes

Front 1

FOSCARNET:

Back 1

1. Interacts directly with herpes virus DNA polymerase
Resistance: point mutations in the viral DNA polymerase.

Front 2

Where is foscarnet sequestred:

Back 2

- In the bones and gradual release (10-20%)
- Plasma Cl is decreased prop. w/ CrCl.
- Excreted unchanged in the urine.

Front 3

A.E. OF foscarnet:

Back 3

1. Nephrotoxicity
2. Electrolyte disturbances: hypocalcemia, mag, kal, phosphatemia or hyperphosphatemia.
3. CNS: (seizures, ha, tremor, irritability, hallucinations)

Front 4

Ganciclovir:

Back 4

- inhibits viral DNA synthesis.
- mono-phosphorylated by virus.
- cessation of chain elongation.

Resistance: reduced intracellular ganciclovir phosphorylation due to mutations in the viral phosphotransferase.

Front 5

a.e. of ganciclovir

Back 5

-MYLEOSUPPRESSION: neutropenia or thrombocytopenia.

Front 6

Cidofovir:

Back 6

- Cytidine nucleotide analog
- phosphorylated by CELLULAR KINASE.

- metabolite: has a prolonged half-life and serve as intracellular reservior.

Front 7

CIDOfovir adverse effects:

Back 7

nephrotoxicity
- probenecid and hydration reduce the risk of nephrot
- adm. with nephrotoxic drugs should be avoided.

Front 8

Cleared by cidofovir:

Back 8

- cleared by glomerular filtration and tubular secretion.
- 90% excreted in the urine.