Antivirals Flashcards
What is the DOC for HSV?
Acyclovir/Valacyclovir
What is the DOC for VZV?
Acyclovir/Valacyclovir
What is the DOC for CMV or CMV+HSV?
Ganciclovir/Valganciclovir
What is the DOC for Hepatitis B?
Tenofovir
What is the MOA for Acyclovir/Valacyclovir? How is it activated, if at all?
Nucleoside analogue → Inhibit DNA synthesis
- Activated by viral thymidine kinase (phosphorylation)
What is the difference between Acyclovir and Valacyclovir?
Valacyclovir is oral and MORE bioavailable than Acyclovir
What is Acyclovir/Valacyclovir the DOC for (2)?
- HSV
- VZV
What is the MOA for Ganciclovir/Valganciclovir?
Nucleoside analogue → Inhibit DNA synthesis
- Activated by viral kinases (phosphorylation)
What is the difference between Ganciclovir and Valganciclovir?
Valganciclovir is oral and MORE bioavailable than Ganciclovir
What is Ganciclovir/Valganciclovir the DOC for (2)?
- CMV
- CMV + HSV
What are the two primary toxicities associated with Ganciclovir/Valganciclovir?
- Myelosuppression
- CNS issues
Acyclovir/Valacyclovir is fairly well-tolerated, but what is the one toxicity associated with it?
Nephrotoxic if HIGH IV dose (be sure to hydrate)
What two medications are the recommended treatments for CMV-resistant organisms? Why are these considered treatments for resistance (think MOA)?
Both are NOT phosphorylated by viral kinases (not at all or by host instead)
- Foscarnet
- Codofovir
What is the MOA for Foscarnet? How is it activated, if at all?
Directly binds to reverse transcriptase
- NO phosphorylation
What is the MOA for Codofovir? How is it activated, if at all?
Inhibits DNA polymerase
- Activated by host phosphorylation
What are the two primary drugs used to treat Influenza? What is the difference between the two (think administration)?
What is the MOA for both of these drugs?
- Oseltamivir (Tamiflu) = oral
- Zanamivir (Relenza) = inhalation
MOA for both: inhibit neuramidase (virus not cleaved from host cell so cannot replicate)
What is the primary toxicity associated with Oseltamivir (Tamiflu)? What is the primary toxicity associated with Zanamivir (Relenza)?
Hint: think about administration
- Oseltamivir (Tamiflu): GI issues (because oral)
- Zanamivir (Relenza): respiratory distress (because inhalation)
At what age is Oseltamivir (Tamiflu) appropriate to administer? What about for Zanamivir (Relenza)?
- Oseltamivir (Tamiflu): >1 year
- Zanamivir (Relenza): >7 years
What is an alternative treatment for influenza that is not Oseltamivir (Tamiflu) or Zanamivir (Relenza)?
Baloxavir Carboxyl (Xofluza) - Just know it exists (also it is single dose)
What is the primary drug used to treat RSV?
Ribavirin
What is the MOA for Ribavirin?
Nucleoside analogue → Inhibits RNA polymerase
- Activated by host phosphorylation
What are the two primary toxicities associated with Ribavirin?
- TERATOGENIC
- Workplace/occupation exposure (especially in healthcare)
What is Tenofovir the DOC for?
Hepatitis B
What are Entecavir and Lamivudine the second and third line treatments for?
Hepatitis B
What is the MOA for Tenofovir, Entecavir and Lamivudine? What do all three treat?
Treat Hepatitis B
- MOA: inhibit HBV DNA polymerase
What are the two medications used to treat Hepatitis C?
- Harvoni (Sofosbuvir-Ledipasvir)
- Epclusa (Sofosbuvir-Velpatasvir)
What is the MOA for both Harvoni (Sofosbuvir-Ledipasvir) and Epclusa (Sofosbuvir-Velpatasvir)? What are both used to treat?
Treat Hepatitis C
- MOA: nucleoside analogues → inhibit DNA replication and assembly
What do Acyclovir/Valacyclovir, Ganciclovir/Valganciclovir, Cidofovir, Ribavirin, Harvoni (Sofosbuvir-Ledipasvir) and Epclusa (Sofosbuvir-Velpatasvir) all have in common?
ALL are nucleoside analogues
- Also treat viruses duh
