Antivirals (Exam 2)

Question 1

What is the mechanism of action of antiviral agents?

Answer 1

Acyclovir (Zovirax):

1) INHIBITS viral DNA polymerase preferentially, inhibiting viral replication
2) Drug is INCORPORATED into viral DNA
3) Immunocompromised patients
4) Systemic: recurrent mucosal & cutanous HSV infections
5) Topical: herpes labialis, mucocutaneous infections

Question 2

What are the 5 common antiviral medications used to manage HSV?

Answer 2

1) Acyclovir (Zovirax)
- 4 dosage forms: Oral, cream/ointment, suspension, & injection

2) valacyclovir (Valtrex)
3) penciclovir (Denavir)
4) docosanol (Abreva)

Question 3

Describe common antiviral medication, acyclovir (Zovirax) used to manage herpes simplex virus.

Answer 3

acyclovir (Zovirax)= HSV1 & **HSV2:

1) MUST be applied EVERY 3 HOURS or no results (apply 6 X per day for 7 DAYS) = compliance is problematic

Question 4

Describe common antiviral medication, valacyclovir (Valtrex) used to manage herpes simplex virus.

Answer 4

valacyclovir (Valtrex)= **HSV2:(genital herpes suppression)

1) In dentistry, given in 2 DOSES only, taken at prodrome

2) 2 gm at prodrome, wait 12
hours, take a second 2 gm dose

3) Some patients DON’T develop lesion
4) If lesion develops, lasts for only 2-4 days (keeps breakouts in check)
5) EXPENSIVE drug, but excellent compliance

Question 5

Describe common antiviral medication, penciclovir (Denavir) used to manage HSV

Answer 5

Penciclovir (Denavir)= HSV1:

1) Small amount applied every 2 hours (lips and face only) for 4 days
2) Compliance problems w/ frequency of application
3) Begin when symptoms first occur (PRODROME PHASE)

**External use ONLY

Question 6

Describe common antiviral medication, Docosanol (Abreva) used to manage HSV

Answer 6

Docosanol (Abreva)= HSV1:

1) Apply 5 X per day; start at prodrome & continue until lesions have healed (ONLY EXTERNAL USE)
2) Do not apply inside of mouth or around eyes
3) Shortens course of lesion to 5-6 days
4) Good for frequent breakouts

Question 7

Describe common antiviral medication, alcohol/benzalkonium chloride used to manage HSV

Answer 7

Alcohol/benzalkonium chloride= HSV1:

1) VIROXYN (Strips lipid coating off virus & kills it on contact-virucide)
2) Professionally dispensed
3) Single dose applicator vial
4) At prodrome, rub medication into lesion until medication is gone (10 sec)
5) Stings! Cauterizes lesion
6) Shortens course of lesion to 3-4 days

Question 8

What is the course of therapy for treating oral viral infections?

Answer 8

1) Can be either primary (gingivostomatitis) or recurrent (lip lesions/intraoral ulcers)
2) Management is primarily palliative
3) Treatment is combination therapy (Antiviral, topical, fluids, vitamins/minerals, rest)
4) DO NOT USE Systemic corticosteroids or antibiotics (they are ineffective)

Question 9

What are the side effects associated with antiviral agents?

Answer 9

1) Bone marrow suppression

2) Blood dyscrasias
a. Thrombocytopenia
b. Leukopenia
c. Aplastic anemia