Antimicrobial therapy - anti-viral drugs Flashcards
What does it means that all anti viral drugs are virustatic
inhibit growth/ replication
Give examples of Herpes viruses
Herbes simple virus
Varicella zoster virus
Epstein-barr virus
cytomegalovirus
What is an antiviral that is active against both HSV and VZV
aciclovir
How is aciclovir activated
Converted to active from by an enzyme (thymidine kinase) coded for by the virus genome
What is the benefits of aciclovir being activated by virus genome
Specific for virus infected cells
Low toxicity for unaffected cells
What do you do with acyclovir in patients with renal impairment
lower the does
What antiviral drugs are used in the treatment of HSV and shingles instead of aciclovor and why
famciclovir and valaciclovir
better bioavailability
ganciclovir is active against what herpes virus
cytomegalovirus
toxic given by IV fusion
What is valganciclovir
prodrug of ganciclovir oral alternative
What needs to be moniitored with valganciclovir and ganciclovir
Blood count for bone marrow toxicity
When is foscarentt used
Used for some HSV, VZV and CMV infections when the infection is resistant to other antifungals
What are features of fosxarent
Highly nephrotoxic and is only given by IV
When is Cidofovir used
for CMV when other anti fungals are inappropriate
Name all the different anti herpes virus drugs
Aciclovir - HSV/ VZV Famciclovir and Valaciclovir - HSV and shingles (stronger) ganciclovir CMV (IV) valganciclovir CMV (oral) foscarnet HSV VSV CMV (IV) (last resort) cidofovir - CMV (last resort)
What is a nucleoside analogue
interfere with the action of the reverse transcription
What therapy is used for HIV
Combination therapy of at least two drugs which are active on different stages of HIV replication
What inhibitors can be used in therapy of HIV
Two nucleoside analogue reverse transcriptase inhibitors
plus non-nucleoside reverse transcriptase inhibitors
or a Protese inhibitor
How is HIV therapy monitored
viral load and CD4+ cell count
What is used to treat chronic hepatitis B and C
Interferon alpha
Lamivudine - hep B
Ribavain
What is the advantage of interferon alpha
taken orally
What is lamivudine mainly used to treat
HIV treatment and Hep B
Zanamavir and oseltamivir are both used in the treatment of what
Influenza within 48 hours of symptoms or as prophalaxis
What nucleoside analogue can be used for the treatment of respiratory syncytial virus
Ribavarin
What is genotypic analysis
sequencing of part of viral genome
What is drug monitoring for in antiviral therapy
ensure therapeutic index
What antiviral drugs can be monitored
some anti HIV drugs and aciclovir
What is an anti HIV for nucleoside analogue
Zidovudine
In Ant- HIV what is the non-nucleoside reverse transcriptase inhibitors or the Protese inhibitor that is used in combination with zidovudine
non-nucleoside reverse transcriptase inhibitors - nevirapine
Protease inhibitor -saquinavir
