Antimicrobials VI Flashcards
oseltamivir
inhibit influenza neuraminidase
-decreased release of progeny
tx of influenza A and B
oseltamivir
zanamivir
zanamivir
inhibit influenza neuraminidase
-decreased release of progeny
acyclovir
guanosine analog
monophosphorylated by HSV/VZV thymidine inase
triphosphate formed
inhibit viral DNA polymerase - chain termination
famciclovir
guanosine analog
monophosphorylated by HSV/VZV thymidine inase
triphosphate formed
inhibit viral DNA polymerase - chain termination
valacyclovir
guanosine analog
monophosphorylated by HSV/VZV thymidine inase
triphosphate formed
inhibit viral DNA polymerase - chain termination
adverse acyclovir
obstructive crystal nephropathy
prevent adverse of acyclovir
hydration - prevent crystal nephropathy
tx of HSV and VZV
acyclovir
famciclovir
valacyclovir
gangciclovir
5’-monophosphate formed by CMV viral kinase
guanosine analog
triphosphate formed by cellular kinases
-inhibit DNA polymerase
chain termination
tx of CMV
gangciclovir
tx for HSV encephalitis
temporal lobe
acyclovir, famciclovir, valacyclovir
tx genital HSV warts
acyclovir, famciclovir, valacyclovir
resistance acyclovir
mutated viral thymidine kinase
resistance gangciclovir
mutated viral kinase
adverse gangciclovir
leukopenia
neutropenia
thrombocytopenia
renal toxicity
more toxic than acyclovir
foscarnet
viral DNA/RNA polymerase inhibitor
and HIV reverse transcriptase inhibitor
binds pyrophosphate binding site of enzyme
no activation by viral kinases
tx of CMV retinitis
gangciclovir
if fails - foscarnet
resistance to foscarnet
mutated DNA polymerase
tx acyclovir resistant HSV
foscarnet
CMV
infect mononuclear cells
EBV
infect B cells
cidofovir
inhibit viral DNA polymerase
-does not require activation viral kinases
clinical use cidofovir
CMV retinitis - immunocompromised
acyclovir resistance HSV
adverse cidofovir
nephrotoxic
coadmin with probenecid and IV saline - prevent toxicity
HIV therapy
high active antiretroviral therapy
started - time of diagnosis of HIV infection
two NRTIs
and one of following
-NNRTI, protease inhibitor, integrase inhibitor
atazanavir
protease inhibitor
darunavir
protease inhibitor
fosamprenavir
protease inhibitor
indinavir
protease inhibitor
lopinavir
protease inhibitor
ritonavir
protease inhibitor
saquinavir
protease inhibitor
protease inhibitor
prevent maturation of new viruses
HIV-1 protease - pol gene
-cleaves polypeptide products of HIV mRNA into their functional parts
ritonavir boost
can enhanced other drug concentration
-inhibit P450
rifampin
CI with protease inhibitor - can decrease protease inhibitor concentration
