Anti Viral Drugs

Question 0

Tamiflu

Answer 0

Tx/prevention of influenza A&B, H5N1. Neuraminidase inhibitor
13yo & up
75mg BID x5 days - for tx within 48 of sxs onset
75mg QD x5 days - prophylaxis of influenza

Abd pain, N/V, HA, concern for neuro effects

Question 1

Approach to interfering with viral infection(4)?

Answer 1

1) inhibit entry (surface receptor blockers)
2) inhibit DNA integration / replication (integrase inhibitors / nucleotide -side analogs)
3) inhibit protein cleavage (protease inhibitors)
4) block release from host cell (neuraminidase inhibitors)

Question 2

Relenza (Zanamivir)

Answer 2

Neuraminidase inhibitor- blocks viral fxn of viral neurominidase protein- prevents viral bidding
Influenza A&B, avian a flu w/in 48hrs onset
Inhaled powder
10mg QD x 10 days
Not for COPD or asthma
N/V

Question 3

Amandatine (symmetrel)

Answer 3

Originally recommended for influenza A- no longer useful

Tx for early Parkinson’s- short term

Question 4

Acylovir/ Zovirax

Answer 4

HSV-1, HSV-2, VZV
Guanosine analog- inhibits viral synthesis- only works against actively replicating organisms
Topical form is ineffective
PO, IV- can cross BBB to tx meningitis & encephalitis
Active tx- 400mg TID
Suppressive tx- 400mg QD
Zoster tx- 800mg TID

Question 5

Acyclovir dosing

Answer 5

Initial outbreak- 400mg TID x 7-10days
Recurrence- 400mg TID x 5 days
Chronic suppression- 400mg TID- up to 12 mos
Zoster- 800mg 5x/day for 7-10 days

Question 7

HAART therapy

Answer 7

Antiviral cocktails:

Consist of at least 3 drugs from 2 different classes- 2 from NRTI, 1 either NNRTI or protease inhibitor

Question 8

Zidovudine(AZT)/ Retrovir

Answer 8

Neucleoside RTI
HIV
Pyrimidine analog- terminates further replication
HA, potentially toxic to bone marrow- may cause severe anemia & leukopenia

Question 9

Saquinavir/ Invirase

Answer 9

Protease inhibitor
HIV, HEP C
Protease enzyme inhibition. Prevents viral protein from being cleaved, replicated and released
GI & abd discomfort. N/V, diarrhea

Question 10

Interferon alpha

Answer 10

HEP B&C, HPV, kaposi’s sarcoma, hairy cell leukemia
Induces host enzymes that inhibit RNA translation
Arthralgias, myalgias, fever, lethary, HA, dizziness, hair thinning, depression.
IM, IV
Pegylated IFN-α may last longer in body- dosed with ribavirin for HEP C

Question 11

Interferon gamma

Answer 11

Chronic granulomatosis dz- sarcoidosis

Question 12

Interferon beta

Answer 12

For relapsing MS

Question 13

Ribavirin

Answer 13

Neucleotide anti-metabolite, anti-viral against DNA & RNA
HEP C, west Nile, haunta virus- little to no effectiveness in HIV/AIDS
Interferes with duplication of viral genetic material
Synergistic effect with IFN- α for tx of HEP C

Question 14

Live attenuated virus

Answer 14

Adenovirus
Measles
Mumps
Rubella
Smallpox
VZV 
Yellow fever
Influenza

Question 15

Killed virus

Answer 15

Polio
Rabies
Hep A
Influenza

Question 16

Conjugate/ recombinant

Answer 16

HiB
Hep B
HPV

Question 17

Trivalent inactivated influenza (TIV)

Answer 17

Anti- viral
Influenza
6mos & older & use during pregnancy
IM

Question 18

Live attenuated influenza virus(LAIV)

Answer 18

Anti-viral
Influenza
Use in healthy individuals- not pregnancy, immunocomprimised, under 2yo, chronic health problems
Nasal spray

Question 19

Gardasil

Answer 19

HPV
Quadrivalent- strains 6,11,16,18
Ages 9-25 and unexposed

Question 20

Cervarix

Answer 20

HPV

Divvalent- strains 16 & 18

Question 21

HIB

Answer 21

Haemophilus influenza type B

Conjugate vaccine

Question 22

Meningococcal

Answer 22

For those living in close proximity to one another- dorms, military

Question 23

Pneumovax

Answer 23

Pneumococcal vaccination
For those over 65yo
Ineffective in those under 2yo
Usu a single lifetime dose- readmin in those vacc. Before age 60yo, or those who are a splenic or nephrotic syndrome