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14 Cards in this Set
- Front
- Back
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HSV is what type of virus?
Oral > genital: Mostly genital: Antigenc cross reaction with: Only natural host for HSV: |
dsDNA
HSV-1 HSV 2 VZV human |
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Hepes replicates where?
Primary infection of HSV is characterized by what? Significance of neonatal HSV? |
epithelial cells - then progresses to ganglia (latent)
lytic stage - high [virus] at infection site commonly fatal (25%) - both mom/child treated with acyclovir |
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Nucleoside analog, similar to guanosine, contains cyclic sugar group:
Characteristics of acyclovir? Why does acyclovir not affect uninfected cells? |
acyclovir
perfect antiviral - specific, non-toxic - highly effective against HSV, also against VZV - guanine derivative, prodrug that gets converted to the tri-phosphate form (activated form) BY THE VIRUS. 1st thymidine kinase not present |
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How often is acyclovir given?
Two other guanosine derivatives: Prodrug of acyclovir, higher bioavailibility, BID: |
TID to 5x/day
Valacyclovir (Valtrex), Famciclovir (Famvir) Valtrex |
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Two guanosine drugs primarily used for CMV:
Differences between these and the other guanosine derivatives? Three ocular antivirals: |
Ganciclovir (Cytovene), Valganciclovir (Valcyte)
bone marrow suppression (primarily neutropenia), renal insufficiency, mutagenic idoxuridine, trifluridine, vidarabine |
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Idoxuridine is what analog?
How is idoxuridine different from acyclovir? Three reasons not to use idoxuridine? |
pyrimidine analog
can be activated in non-infected cells (less selective) mutagen, carcinogen, crosses placenta |
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DOC for external genital warts:
MOA? What is unique about its SE's? |
podofilox
inhibits cell mitosis worse in females then males |
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Another drug for genital warts?
MOA? SE's: What is adjunct therapy with imiquimod? |
Imiquimod
induces cytokine formation (really unknown) erythema (97%), flaking/dryness (93%), duct tape |
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Which drugs work by incorporating Iodine:
Inhibits thymidine kinase: Stimulates interferon A: must be dosed at least TID: |
idoxuridine
5 derivatives of acyclovir Imiquimod acyclovir (PO) |
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Oral prodrug:
Only ocular route: Can be given IV: SE's worse in women than men: |
acyclovir, valacyclovir, famciclovir, ganciclovir, valganciclovir
idoxuridine, trifluridine, vidarabine ganciclovir podofilox |
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Specific adverse events to the smallpox vaccine?
Who should not get the smallpox vaccine? Treatments? |
exzema vaccinatum, inadvertent inoculation, usually 5-19 days post exposure
pregnant women, people w/ eczema/atopic dermatitis, immunosuppression, skin conditions VIG, Cidofovir, ophthalmic antivirals |
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Serious SE's from VIG?
Side effects from cidofovir? |
hypotension, anaphylaxis, renal dysfunction, aseptic meningitis syndrome (AMS)
Renal, neutropenia, proteinuria, anterior uveitis/iritis, metabolic acidosis |
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Efficacy of VZV vaccines (Oka-Merck strain):
How long does the immunity last? Schedule? Recommended for who? |
70-90% from infection, 95% from serious disease
10 years at least 2 doses - 1st at 12-15 mo., then 4-6 y/o kids, health care workers without evidence of varicella immunity post exposure, immunocompromised |
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Most common SE from VZV vaccine?
Contraindications for VZV vaccine? How should you store the MMRV vaccine? |
local reactions - 20%
immunosuppression, allergic rxn, pregnancy, moderate/severe illness NOT REFRIGERATED - frozen |
