Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
27 Cards in this Set
- Front
- Back
|
Antivirals
|
- Viruses use use host cell's metabolic pathways for reproduction - limits MOA for antiviral drug action
- Antibacterials and antifungals have little or no effect - Most antivirals are antimetabolites of endogenous nucleosides and prevent replication of viral nucleic acid - Some antivirals inhibit the uncoating of viral nucleic acid or inhibit post translation of viral proteins |
|
|
Herpes virus infections
|
- Herpes viruses are DNA viruses
1. Herpes Simplex Virus - Herpes genitalis (HSV II) - Herpes labialis - cold sores (HSV I) - Herpes keratoconjunctivitis - Herpes encephalitis 2. Varicella-zoster virus (VZV) - Chicken pox (varcella) - Shingles (herpes zoster) 3. Cytomegalovirus - CMV retinitis - CMV esophagitis - CMV colitis - These diseases mostly occur in immunosuppressed patients; can also be passed from mother to child |
|
|
Drugs for herpes virus infections
|
- All are nucleoside analogs, except foscarnet and docosanol
- Most contain purine/pyrimidine base - Viral resistance develops with all, varies with drug and viral pathogen |
|
|
Acyclovir
|
- Treatment for HSP and VZV
- Can cause nephrotoxicity - elevated BUN & creatinine - The PO form has low bioavailability, so must be taken 5x/day - IV for is for serious systemic infections - Topical form is used for genitals - Available as oral suspension for chicken pox in kids |
|
|
Valcyclovir
|
- Derivative of Acyclovir
- Used for treatment of HSP & VZV - Had increased bioavailability so less frequent dosing - Less ADR's than Acyclovir - More effective than Acyclovir for shingles |
|
|
Famciclovir
|
- Derivative of Acyclovir
- Used for treatment of HSP & VZV - Had increased bioavailability so less frequent dosing - Less ADR's than Acyclovir - More effective than Acyclovir for shingles |
|
|
Penciclovir
|
- Active metabolite of famciclovir
- Topical use for herpes labialis - Potentially used for Epstein-Barr virus as well |
|
|
Docosanol
|
- First OTC topical for herpes labialis
- NOT a nucleoside analog |
|
|
Zostavax SC injection
|
- Use for prevention of herpes zoster in pts >50 yo
- Live attenuated varicella zoster virus - Can reduce shingles cases by 50% and patients who get shingles will get milder cases - 1/3 of patients are also less likely to develop postherpetic neuralgia |
|
|
Ganciclovir
|
- Used for TREATMENT of CMV retinitis in immunocompromised pts and PREVENTION of CMV diseases in HIV and transplant pts
- PO form has low bioavailability - ADRs: bone marrow suppression and retinal detachment |
|
|
Valganciclovir
|
- Same indication as Ganciclovir
- Prodrug - can give less frequently |
|
|
Cidofovir
|
- Same indication as Ganciclovir
- Reserved for more resistant viruses |
|
|
Foscarnet
|
- Tx of CMV retinitis in immunocompromised pts when ganciclovir alone has failed
- Often given in combination with ganciclovir to reduce toxicity - ADR's: acute renal failure, hematologic deficiencies, seizures, cardiac arrhythmias, heart failure and pancreatitis |
|
|
Ocular antivirals for CMV
|
1. Ganciclovir - implant
2. Fomiversin - injection |
|
|
Influenza virus
|
- Types A & B
1. Type A - moderate/severe illness 2. Type B - milder, primarily affects children - Clinical presentation is abrupt onset of fever, malaise, sore throat and non-productive cough |
|
|
Flu vaccine guidelines - 2012
|
- Vaccination now recommended for ALL persons > 6 mo
- All children 6mo-8y being vaccinated for the first time should receive 2 doses (4 weeks apart) |
|
|
Influenze virus vaccine
|
- Inactivated virus
- Do NOT use in pts allergic to eggs; pts who can tolerate baked goods can usually tolerate the vaccine |
|
|
Flumist
|
- Intranasal influenze vaccine
- Live attenuated virus; do NOT used in immunocompromised patients - Can be used primarily in healthy patients ages 2-49 yo |
|
|
Drugs for Influenza A
|
- MOA - inhibits only replication of influenza A only by blocking viral membrane matrix protein
- Not recommended per 2009 guidelines 1. Amantadine 2. Rimantadine |
|
|
Drugs for Influenza A & B
|
- Indications: treatment and prevention of seasonal influenza and H1N1
- Effectiveness: decreases the severity of symptoms and shortens duration of illness only if taken within 24-48 hours of symptom onset 1. Oseltamivir 2. Zanamivir |
|
|
Ribafavirin
|
- Pregnancy category X
- Indications: aerosol for sever lower respiratory infections d/t respiratory syncytial virus (RSV) - Reduces duration of illness, allows children to be removed from ventilator sooner, improves arterial oxygenation - ADRs: serious pulmonary and cardiovascular effects |
|
|
Palivizumab
|
- Used for prevention of serious lower respiratory tract infection caused by RSV in infants and children
|
|
|
Interferons
|
- Recombinant DNA technology drug with immunomodulating and antiproliferative effects
- Can be used in tx of Hep B & C - Can also be used in tx of certain cancers and tx of anogenital warts |
|
|
Ribaviran
|
- Pregnancy category X
- Given in combo with interferon alpha 2b for the treatment of chronic Hep C in patients with compensated liver disease - Non-FDA tx: various viruses including west nile, hemorrhagic fever virus, etc. |
|
|
HPV vaccine - Gardasil
|
- Indicated to prevent diseases caused by HPV virus types 6, 11, 16 and 18 (cervical cancer and genital warts) in young women b/w 9-26 yo
- Given in 3 doses at 0, 2 and 6 months - Has potential to cause guillion-baray syndrome, thrombosis, bells palsy, vomiting and seizures |
|
|
Rotavirus vaccine - RotaTeq
|
- LIVE oral vaccine for rotavirus
- Rotavirus M/C cause of severe diarrhea and vomiting in young children - Given to infants at age 2, 4 and 6 months |
|
|
Avian flu vaccine - H5N1
|
- Not availably commercially
- Reserved for distribution in the event of an outbreak |
