anti virals and treatment of common viral infections

Question 1

2 types of therapeutic options

Answer 1

antiviral drugs
immune modulation

Question 2

examples of antiviral drugs

Answer 2

• Aciclovir & valaciclovir
• Ganciclovir & valganciclovir
• Foscarnet
• Ribavirin
• CoVID antiviral

Question 3

examples of immune modulation

Answer 3

• Lifting immunosuppression
• Specific Immunoglobulins
(VZIG and HBIG)
• Human Normal Immunoglobulin • Rituximab and Mab/Nib (risks)
• CoVID immunomodulators

Question 4

describe aciclovir

Answer 4

an anti herpesvirus drug

high selective toxicity

typically used to treat or prevent HSV1 HSV2 VZV infection

few side effects

Question 5

mechanism of action of ACV

Answer 5

• Pro-drug, activated to a monophosphate by the viral thymidine kinase only in herpesvirus infected cells
• Host cell kinases then adds a second and third phosphate group
• Aciclovir triphosphate competitively inhibits herpesvirus specific DNA polymerases
• Further viral DNA synthesis is inhibited without affecting other normal cellular functions

Question 6

For which herpesvirus infections is acyclovir useful?

Answer 6

genital herpes
herpes labialis/stomatitis
disseminated herpes
herpes keratitis
chickenpox & shingles

Question 7

complications of chickenpox

Answer 7

secondary bacterial infection - group A strep

encephalitis/pneumonitis/stroke

Question 8

who is at greatest risk of complications from chicken pox

Answer 8

babies under 4 weeks
adults
immunocompromised people
pregnant women

Question 9

when do we use IV acyclovir

Answer 9

Oral aciclovir-relatively poor oral bioavailability, necessitating frequent dosing

• Severe herpes virus infections
• Herpes virus encephalitis
• Disseminated herpes (neonatal or congenital herpes) • Severe shingles/opthalmic zoster
• Herpes viruses in immunocompromised patients
• Extensive eczema herpeticum