Antivrals Continued Flashcards
HSV + VZV
Acyclovir
Special Considerations
- Must be initiated w/in 48-72 hrs of onset
- Topical + IV (suppressed HIV, transplant, invasive disease)
- Patient expectations: not curative
CMV Infection Drugs?
- Ganciclovir
- Valganciclovir
- Foscarnet
Ganciclovir
Side Effects:
- Black Box Warning: bone marrow toxicity
- Highly alkaline, teratogenic, carcinogenic
Special Considerations:
- Hydrate aggressively
- Monitor renal function + adjust accordingly
- Avoid direct skin contact
Valganciclovir
Special Considerations:
- DRUG OF CHOICE for Tx + Px
- PO only
- Don’t confuse with valacyclovir
Foscarnet
Side effects:
- Highly NEPHROTOXIC
Hep B Drugs?
- Entecavir
- Lamivudine
- Telbivudine, Tenofovir, Adefovir
- Interferon alfa
Entecavir
Side effects:
- Dizziness, fatigue
Lamivudine
Special Considerations:
- Epivir dosage form (less than HIV)
Resistance is common (at 5 years)
Telbivudine, Tenofovir, Adefovir
Special Considerations:
- PO
Interferon alfa
Special Considerations:
- SC
Hep C Drugs?
- Interferons
- Ribavarin
- Simepravir
- Sofosbuvir
Interferons
Side effects:
- Flu-like (HA, myalgias, fatigue, fever, chills)
- Improves as treatment continues
Special Considerations:
- CI: hepatic decompensation, autoimmune dz, pregnancy, arrhythmia
Ribavarin
Side effects:
- Hemolytic anemia, teratogenic
Special Considerations:
- Consider handling capsules + pregnancy precautions
Simepravir
Side effects:
- Lots of DRUG INTERACTIONS!!
Special Considerations:
- Taken WITH food
- Assess Q80K mutation
Sofosbuvir
Special Considerations:
- $1000 per tablet!!
- Pan-genotypic activity
- Makes it possible to tx some pts w/out interferon
