Anti-Viral and Fungal Flashcards
What are virus
Obligate intracellular parasite
Uses host cell to replicate
What issues
Limited proteins for drugs to target
Most targets intracellular
Toxicity common
What are most drugs
Nuceloside analogue that inhibits nucleic acid synthesis
What are Rx options for virus
Prophylaxis - PREP
PEP - post exposure
Overt
Suppressive if can’t eradicate from latent
Examples of anti-viral
Aciclovir
Valaciclovir
Foscarnet
Oseltamivir / Zamivir
Aciclovir
Oral, IV, ointment, cream
Low toxicity
Nucleoside analogue
What is used if resistant to nucleoside analogue
Foscarnet
What does Oseltamivir do
Blocks release of virus
Used in influenza
HSV
Oral acyclovir
Chicken pox
Treat if at risk of complication
- Baby
- Immunocompromised
- Pregnant
Shingles
Rx within 72 hours to prevent post-herpetic neuralgia
CMV
Rx if life or eye threatening as highly toxic
- HIV
- CMV retinits
- Post transplant pneumonitis
- Neonate with symptomatic congenital
HIV
Combination ART
Chronic hep B
Pegylated interferon
Nucleoside analogue - tenofovir
Chronic hep C
Pegylated interferon
Ribavirin
Protease inhibitor - telaprevir
CAN CURE
Influenza A and B q
Within 48 hours or any if immunocompromised
RSV
Ribavirin but rare
Resistance
Use forcarnet
HIV resistance test
What do azole anti-fungal do
Block ergosterol synthesis
AE
Hepatotoxic
p450 inhibitor
Examples and use
Fluclonazole / Itraconazole
- Candida
- Aspergillus
What do Polyenes do
Lysis of Ergosterol
Examples
Amphotericin B
Nystatin
When do you use Amphotericin
Broad spec
Used in severe fungal / meningitis
IV only
SE
Nephrotoxic
Hypokalaemia
Flu
Terbinafine
Used for tinea / nails
Echincandins (Caspofungin)
Used candida / aspergillum
