Aciclovir ,Valaciclovir, Famciclovir ,Cidofovir , Foscarnet

Question 1

Aciclovir MOA

Answer 1

guanosine nucleoside analog
(“Purine shaped luggage”)

-converted to acyclovir monophosphate via virus encoded thymidine kinase

(“Hermes with “P” luggage tag”)

→ converted to acyclovir triphosphate by cellular kinases
(“Bag checkers with P tags”)

→acyclovir triphosphate incorporates into replicating DNA, halting synthesis
(“Baggage jam”)

Question 2

Cidofovir/Foscarnet

MOA

Answer 2

directly inhibit viral DNA polymerase
(“Conveyer belt stop switch”)

Question 3

Cidofovir/Foscarnet are active against …

Answer 3

they don’t require phosphorylation by the viral kinase

• active against aciclovir/ganciclovir VZV resistant HSV, CMV,
  (“Luggage car net”)
• This may be important with immunocompromised patients​

(““P”access badge”)

Question 4

what is the major benefit of Valciclovir over Aciclovir ?

Answer 4

valcyclovir has improved oral bioavailability

• suppressive therapy for yearly multiple episodes of recurrence
  (“Daily rate for frequent flyers”)

(“Open mouth”)

Question 5

What is the treatment for serious HSV and VZV infections?

Answer 5

IV acyclovir treats HSV encephalitis
(“Red winged helmet”)
(“ivy”)

IV acyclovir treats neonatal infection
(“Baby Hermes helmet”)
(“ivy”)
​

Question 6

preferred treatment for varicella zoster virus and shingles ?

Answer 6

Famciclovir and Valaciclovir are preferred over acyclovir due to superior activity and less frequent dosing for VZV

(“Family value”)
(“Zues”)

Question 7

IV Aciclovir is used as a prophylactic treatment of HSV in which cases ?

Answer 7

in immunocompromised states
(“Cane”)

important in pregnant women with active recurrent genital herpes
(“Pregnant”)

Question 8

IV aciclovir Side effects

Answer 8

can cause interstitial nephritis crystalline nephropathy
(“Kidney sharps”)

-delirium, confusion, vertigo, hallucinations