Antivirals

Question 1

When is the best time to treat viral infections like recurrent herpes?

Answer 1

During the prodrome phase - The time before a viral outbreak (usually herpes)

Question 2

What is the primary herpetic infection vs recurrent?

Answer 2

• Primary - Gingivostomatitis (ulcers along the gingival margin on palate that may spread to buccal mucosa, lips, tongue, floor of mouth, gingiva)
• Recurrent - lip lesions, intraoral ulcers

Question 3

What does treatment of viral infections include?

Answer 3

Combinations :

• Antiviral drug
• Topical anesthetics
• Fluids, vitamins/minerals, rest

Question 4

When is a viral infection contagious?

Answer 4

Vesicular lesions, vesicle breaks open.

They last about 10 days

Question 5

What do antibiotics do to fungal infections?

Answer 5

They are ineffective for treatment of viral herpes lesions

Question 6

Systemic corticosteroids are ___________ for use during viral illnesses.

Answer 6

Contraindicated - prolongs viral infection

Question 7

How are antivirals named, and what are the major antivirals?

Answer 7

“…vir”

• acyclovir (Zovirax) cream
• acyclovir and hydrocortisone (Xerese)
• penciclovir (Denavir)
• famciclovir (Famvir)
• valacyclovir (Valtrex)
• docosonal (Abreva) = OTC
• benzalkonium 0.13% in isopropyl alcohol (Viroxin) = professionally dispensed

Question 8

How does acyclovir (Zovirax) work?

Answer 8

Inhibits viral DNA polymerase preferentially, inhibitting viral replication (drug is incorporated into viral DNA)

Question 9

What drug is approved for used in immunocompromised patients for viral infections?

Answer 9

acyclovir (Zorivax)

Question 10

What forms can acyclovir (Zovirax) be taken?

Answer 10

Systemic - recurrent mucosal and cutaneous herpes simplex infections

Topical - herpes labialis, mucocutaneous infections

Question 11

What should be used cautiously if the patient is immunocompromised?

Answer 11

acyclovir and hydrocortisone - steroid component problemativ

Question 12

What antiviral drugs can be used during prodrome phase to prevent the outbreak of herpes simplex?

Answer 12

1. famciclovir (Famvir) - very expensive $$$
2. valacyclovir (Valtrex) - 2 doses only, 12 hours apart

Question 13

When valacyclovir is metabolized, what does the metabolite turn into?

Answer 13

acyclovir

Question 14

How is docosanol (Abreva) used?

Answer 14

Topical - applied 5 times a day. more affordable

Question 15

How does benzalkonium chloride 0.13% in isopropyl alcohol (Viroxyn) work?

Answer 15

Rub medicaiton into lesion (stings) - and it strips the lipid coating off the virus and kills it on contact in affected area.

Question 16

Viroxyn is considered a what?

Answer 16

Virucide

Question 17

What are the side effects of all antiviral drugs taken systemically?

Answer 17

• Bone marrow suppression
• Blood dyscrasias (thrombocytopenia, leukopenia, aplastic anemia)