Antivirals Flashcards
Are antivirals virustatic or virucidal
All are Virustatic
4 reasons for antiviral therapy
- Prophylaxis
- Pre-emptive therapy (when evidence of infection is detected, before symptoms apparent)
- Overt disease
- Suppressive therapy (to keep viral replication below the rate that causes tissue damage in asymptomatic infected patient)
When to use antivirals in Herpes simplex
- Mucocutaneous: oral, genital, eye, skin
- Encephalitis
- Immunocompromised
When to use antivirals in Chickenpox
- Neonate
- Immunocompromised
- Pregnant
When to use antivirals in Shingles
Decreases post-herpetic neuralgia in the immunocompetent host IF begun within 72 hours of onset of symptoms
What antivirals are used for HSV & VZV and their route
- Aciclovir (oral, iv, eye ointment, cream)
- Valaciclovir (oral)
- Famciclovir (oral)
- Foscarnet (iv)
How do aciclovir-like drugs act in infected vs uninfected cells
Aciclovir-like drugs are only active in herpes infected cells, low toxicity in uninfected cells
What is CMV
- Cytomegalovirus (CMV) is a common virus that belongs to the herpes family of viruses.
- Usually doesn’t cause any symptoms
When and how to treat CMV
- Only treat life or sight threatening infections
- Neonates who contracted congenital with symptoms will require hospitalisation until antiviral therapy is completed
- Ganciclovir (iv, ocular implant)
- Valganciclovir (oral)
- Cidofovir (iv)
- Foscarnet (iv)
Treatment for chronic hep b
- Pegylated interferon alpha
- Nucleoside/tide analogues (Tenofovir, Adefovir, Entecavir)
Treatment for chronic hep c
- Pegylated interferon alpha & ribavirin (oral)
- Protease inhibitor (telaprevir & boceprevir)
Influenza A or B
- Oseltamivir
- Zanamivir
(Role in both treatment and prophylaxis. Not always indicated, but if used, should usually start 48 hours of onset of symptoms/contact.)
When would monitoring of aciclovir peaks and troughs be needed
Patients with renal impairment
