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
Topicals for cold sores
Acyclovir (Zovirax), abreva OTC - penciclivir (denovir)
Cold sore - OTC
Abreva
Cold sore - topical rx
Penciclovir (denavir)
HSV
Acyclovir (Zovirax)
Alt. Famciclovir
HSV - suppressive therapy
Acyclovir (Zovirax)
Herpes Zoster
Acyclovir (Zovirax)
Alt. Famciclovir
Chicken pox
Acyclovir (Zovirax)
Alt. Famciclovir
Acyclovir resistant HSV
Foscarnet (Foscavir)
Ganciclovir resistant CMV
Foscarnet (Foscavir)
CMV retinitis
Ganciclovir or valganciclovir
Chronic hepatitis
Ribavirin
Severe RSV (bronchiolitis)
Ribavirin