Antivirals Flashcards
Oseltamivir (Tamiflu)
PO Neuraminidase Inhibitor Flu A/B Well tolerated SE: n/v
Zanamivir (Relenza)
Inhalation
Neuraminidase Inhibitor
Flu A/B, kids > 5 yrs old
SE: bronchospasm
Oseltamivir and Zanamivir MOA
prevents infected cells from allowing virus to leave cell to infect another cell
Acyclovir (Zovirax)
PO/Top/IV
HSV 5x day x 10 days
shingles 5x day x 7-10 days
chickenpox QID x 5 days
Antivirals (most) MOA
inhibits DNA polymerase
Famciclovir (Famvir)
PO BID-TID
HSV, shingles, chickenpox
*Not as effective as Acyclovir
Prodrug of Penciclovir
Valacyclovir (Valtrex)
PO BID x 7-10 days
cold sores
Prodrug of Acyclovir
Penciclovir (Denavir)
Top (cream) q 2hrs x 4 days
cold sores
DOC HSV, Shingles and Chickenpox
Acyclovir
Ganciclovir (Cytovene; Vitrasert)
PO (+food)/IV(slow)/Eye implant
CMV retinitis (100 times greater activity than Acyclovir) - IV q 12 hrs x 14-21 days then qd x 5-7 days
SE: N/V/D, neutropenia
Valganciclovir (Valcyte)
PO BID x 21 days then QD
CMV retinitis
Preg C; Lact L3
Prodrug of Ganciclovir
Foscarnet (Foscavir)
IV TID x 14-21 days
Ganciclovir/Acyclovir resistant HSV, CMV, VZV (last resort!)
SE: hypoCa, hypoMg, seizures, arrythmias, nephrotoxic
Hard to tolerate!
Preg C; Lact L4
Ribavirin (Copegus, Rebetol, Virazole)
PO BID x 24-48 weeks (weight based dosing)
Only Chronic Hep C and Severe RSV (bronchiolitis)
SE: hemolytic anemia, bronchospasms
Avoid if CrCl<50
Preg X: Lact L4
Renal considerations for antivirals that treat HSV, CMV, Varicella
All require renal dosing except Penciclovir.
What antivirals can be given IV?
Acyclovir, ganciclovir and foscarnet
