antiviral, flu, rsv, covid-19 drugs Flashcards
What are the challenges of antiviral therapy?
Limited due to host cells, rapid mutation, host damage, and narrow spectrum of activity.
What do most antiviral drug names have in common?
They often contain “viral” in the name.
What is the drug of choice (DOC) for HSV and VZV?
Acyclovir, Valacyclovir, or Famciclovir.
What forms can acyclovir be given in?
IV, PO, Topical.
Which patients are at higher risk of herpesvirus resistance?
Transplant recipients and patients with AIDS.
What are the adverse effects of IV acyclovir?
Phlebitis, nephrotoxicity.
What are the adverse effects of PO acyclovir?
GI upset, headache.
What is a common adverse effect of topical acyclovir?
Stinging sensation.
What is the DOC for CMV?
Ganciclovir, Valganciclovir, Cidofovir, or Foscarnet.
What are the adverse effects of ganciclovir?
Bone marrow suppression (absolute neutrophils <500/mm³ or platelets <25,999/mm³), fever, headache, nausea, diarrhea, reproductive toxicity.
What precautions should be taken when administering ganciclovir?
It is a hazardous drug and should be given slowly.
Which type of influenza is the most infectious and causes pandemics?
Type A.
Which influenza type is milder and has no major subtypes?
Type B.
Which type of influenza has symptoms similar to the common cold and has no vaccine?
Type C.
Which influenza type only affects cattle?
Type D.
Who is at high risk for complications from influenza?
Children <5 years (especially <2 years), pregnant patients (up to 2 weeks postpartum), adults >50 years (especially >65 years), long-term care residents, American Indians & Alaskan Natives, immunosuppressed individuals, and those with chronic conditions (respiratory, neurologic, cardiac, hematologic, endocrine, renal, hepatic, metabolic).
What is the first-line strategy for influenza prevention?
Vaccination.
How often does the flu vaccine change?
Yearly.
What are the two types of flu vaccines?
Inactivated (>6 months old) and live attenuated (healthy people 2–49 years old).
How long does it take for flu vaccine protection to develop?
1-2 weeks, lasting 6+ months.
What is the only contraindication for the flu vaccine?
Severe anaphylaxis.
What are common adverse effects of the flu vaccine?
Injection site pain, fever, myalgia, malaise (1-2 days for first-time recipients).
What are the possible side effects of live attenuated influenza vaccine (LAIV)?
Rhinorrhea, nasal congestion, lethargy, headache, sore throat, myalgias, mild fever, decreased appetite.
Which syndrome is associated with a small risk after flu vaccination?
Guillain-Barré syndrome.
What class of drugs is used to treat influenza viruses?
Neuraminidase inhibitors.
When should oseltamivir (Tamiflu) be given?
ASAP, within 2 days of symptom onset.
Who can receive oseltamivir prophylactically?
Family members of an infected person (within 48 hours for 10 days), nursing home residents, institutionalized/high-risk individuals (up to 42 days).
What are the adverse effects of oseltamivir?
Headache, nausea, vomiting.
What is the primary drug for RSV prophylaxis?
Palivizumab (IM).
What is the primary drug for RSV treatment?
Ribavirin (nebulizer/ventilator).
What precautions are needed when administering ribavirin?
Use a negative-pressure or specially ventilated room (hazardous drug).
What are the adverse effects of ribavirin?
Sudden worsening of respiratory function.
What are the adverse effects of Remdesivir?
Nausea, headache, cough, diarrhea, dyspnea, fatigue, loss of taste & smell, dizziness, chills.
What are the adverse effects of Molnupiravir?
Diarrhea, nausea, dizziness.
What are the general adverse effects of COVID-19 antivirals?
Taste disturbance, diarrhea.
Why is drug interaction a concern with COVID-19 antivirals?
They are CYP substrates and can interact with other medications.
