Antivirals Flashcards

1
Q

What are the three mechanisms of antivirals?

A

Inhibition of viral genome replication

Inhibit viral uncoating

Inhibition of viral release

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2
Q

What is the mechanism of acyclovir?

A

Phosphorylated via HZV or VZV thymidine kinase

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3
Q

What is the distribution of acyclovir?

A

Good CSF penetration for treatment of viral meningitis

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4
Q

How is acyclovir eliminated?

A

Renally

Requires dose reduction

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5
Q

What are the adverse effects of acyclovir?

A

Reversible nephrotoxicity

Crystalline nephropathy with high dose

CNS - HA, Hallucinations and Seizures

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6
Q

What is the mechanism of Valacyclovir?

A

PO, essentially completely converted to acyclovir

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7
Q

What are the symptoms and treatment of HSV encephalitis?

A

Fever, Focal neurologic symptoms

Treatment - IV acyclovir

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8
Q

What topical antiviral is used to treat oral herpes simplex?

A

Dcosanol (Abreva)

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9
Q

What topical antivirals are used to treat genital/perianal warts?

A

Imiquimod

Podofilox

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10
Q

What is podophyllin used for?

A

25% liquid administered in clinic directly to wart

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11
Q

What is used to treat CMV Retinitis?

A

Ganciclovir

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12
Q

What is the MOA of Ganciclovir?

A

Similar to acyclovir, but 10x more potent than acyclovir against CMV

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13
Q

What are the adverse effects of Ganciclovir?

A

CNS w/ Behavior changes and headache

N/V

Neutropenia and Thrombocytopenia

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14
Q

What is Valaganciclovir used to treat?

A

CMV retinitis

CMV prophylaxis

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15
Q

What is used to to treat HSV cold sores?

A

Penciclovir as topical cream

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16
Q

What is used to treat HSV and HZ?

A

Famciclovir

17
Q

What is the mechanism of Penciclovir and Famciclovir?

A

Similar to that of acyclovir

18
Q

What is the use of Cidofovir?

A

Reserved for CMV retinitis when other treatments fail

Administer with normal saline to decrease chances of nephrotoxicity

19
Q

What is the MoA of Foscarnet (Foscavir)?

A

Competes for pyrophosphate in viral DNA polymerases

20
Q

What are the ADRs of foscavir?

A

Nephrotoxic

Seizures, Anemia, Neutropenia

EKG changes - 1st degree AV Block

Hyper/Hypotension

21
Q

What are the clinical uses for Foscavir?

A

Second line agent

CMV in AIDS patients

Acyclovir resistant Herpes Simplex in immunoscompromised ptns

22
Q

What is the MoA of Amantadine and rimantadine?

A

Prevents virus from entering host cell

23
Q

What does amantadine require that rimantadine does not?

A

Amantadine requires renal adjustment

Rimantadine does not

24
Q

What are the ADRs for amantadine and rimantadine?

A

Confusion, Insomnia

More pronounced with amantadine

25
What is the clinical use of amantadine and rimantadine?
Treat and prevent Influenza A Amantadine has a small roll in Parkinsons
26
What is the MoA of Osteltamivir and Zanamivir?
Inhibits neuroaminidase which is required for the release of the virus from infected cells
27
What are the ADRs of Osteltamivir?
PO causes GI side effects
28
What are the ADRs of Zanamivir?
Dry powder may cause wheezing and bronchospasm Avoid COPD/Asthma patients
29
What are the clinical uses of osteltamivir and zanamivir?
Both Px and Tx Influenza types A and B