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10 Cards in this Set

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Acyclovir
HSV
EBV
VZ
guanosine analog, gets p-ed by thymidine kinase
incorporates into the DNA strand and terminates replication/ reading.
Also competes for deoxy GTP
Acyclo-GTP inhibits DNA polymerase.
Resistance: changes in the thymidine kinase or its reduction in amount
oral, IV, topical
oral bioav 15 percent
85 excreted by kidney unchanged
min ddi : methotrexate
min SE
t/2 2 hours
Good CNS penetration
concentrated in breast milk
Foscarnet
CMV
Resistant Herpes
Is not phosophorylated
Bind and inhibits reverse transcriptase
Binds to the pyrophosphate site on DNA polymerase
Ony IV: controlled infusion rate
Excreted: mostly renal unchanged
attention in renal pts
Nephrotoxic, most often in 2nd week
Hypocalcemia, chelates CA, especially in pts on pentamidine (anti-protozoal PCP prophylaxis)
CNS, anemia, N and D, fever, hepatotox
Gancyclovir/ Valgancyclovir

SE
thrombocytopenia
granulocytopenia
teratogenic in animals
caution and dose adjustment in renal patients, as it is excreted unchanged in urine
A protease inhibitor that causese minor GI se, N and D, and its concentration is elevated by food six fold
saquinavir
acyclovir SE
Neurotox (tremor, delerium)
Nephrotox (may crystallize and precipitate)
DDI with methotrexate (tubular excretion)
What Herpes agent should not be used orally?
Penciclovir (topical or IV)
Pro-drug for Penciclovir?
Famciclovir
One key indication for Famciclovir?
Post-herpetic neuralgia
SE of valcyclovir
TTP
and
HUS
How should Foscarnet be given?
And all about Foscarnet :
IV, controlled infusion rate
excreted in urine
caution in renal patients
CMV, resistant Herpes
No phosphorylation is needed
Inhibits RT
Binds to pyrophosphate site on DNA polymerase
Nephrotox
Hepatotox
Hypocalcemia (particularly on pentamidine) - Chelates Ca
CNS effects
N and D
Anemia, fever