Antiviral - others Flashcards
Acyclovir MOA
Guanosine nucleoside analog that needs to be phosphorylated via thymidine-kinase before it can be incorporated into viral DNA to inhibit viral DNA polymerase
Acyclovir resistance
Absence of thymidine-kinase
Cidofovir MOA
Directly inhibits DNA polymerase without the need for intracellular activation
Cidofovir treatment
Resistant HSV
CMV
VZV
Foscarnet MOA
Directly inhibits viral DNA polymerase without the need for intracellular activation
Foscarnet treatment
Resistant HSV
CMV
VZV
What medication should you choose for daily suppressive therapy?
Valacyclovir b/c of it’s increased oral bioavailability
IV Acyclovir treatment
HSV and VZV
HSV encephalitis
Neonatal HSV
What medications can be used in the treatment of varicella zoster virus (shingles)?
Acyclovir
Valacyclovir**
Famciclovir**
Effective if given within 3 days of onset of symptoms
Adverse effects of HSV treatments?
Interstitial nephritis
Crystalline nephropathy
CNS issues
CMV treatment?
Ganciclovir Valganciclovir Cidofovir Foscarnet Probenecid
Describe the classic CMV scenario?
Person complains of progressive visual impairment, non-compliant with anti-retroviral medications and a CD4 count less than 50
Ganciclovir MOA
Guanosine analog that is phosphorylated 3 times, incorporates into viral DNA, and eventually inhibits viral DNA polymerase
Valganciclovir MOA
Prodrug of ganciclovir with better bioavailability
Ganciclovir and Valganciclovir adverse effects?
Myelosuppression
