Block 4 - Viral Infections Flashcards
Acyclovir vs Valacyclovir, which is the pro drug?
Valacyclovir
Acyclovir and Valacyclovir AE?
Neurotoxicity and AKI
Acyclovir and Valacyclovir MOA?
Phosphorylated by Thymidine kinase
Competitively inhibits viral DNA polymerase
Bamlanivimab use and counseling point?
For mild/moderate COVID-19
Admin within 10 days of symptoms onset
Cidofovir AE/monitoring?
Must be administerd w/ probenecid
Must also be prehydrated w/ 1L of NS
Cidofovir counseling points?
Sulfa allergy
Use back-up method for 3 months
Foscarnet AE?
Weird dosing
Must be admin w/ hydrating fluids
Electrolyte wasting
Nephrotoxic
Valganciclovir/ganciclovir AE?
Bone marrow suppression, leukopenia
AKI (BMP at baseline and at least weekly)
Letermovir indication?
CMV prophylaxis in bone marrow transplant
Letermovir AE?
Inhibits CYP3A4
Remdesivir AE?
LFT elevations
Ribavirin AE?
BBW: hemolytic anemia, pregnancy
Many toxicities
DOC of HSV?
Acyclovir
DOC of CMV?
Ganciclovir
How is CMV transmitted?
Direct contact of fluids
S/Sx of CMV in immunocompromised pt? HIV? Congenital?
Immunocompromised = viremia
HIV = retinitis + colitis
Congenital = mental retardation + deafness
Which Rx is used for resistant CMV? AE?
Foscarnet + Cidofovir (give w/ probenecid)
Give fluid replacements
VZV infectious period?
48hrs before vesicle formation through 4-5 days after vesicle crust over (so avoid contact until 4-5 days after lesions heal)
Zoster Sx?
Unilateral vesicular eruption w/ dermatomal distribution
Tx of chickenpox/shingles?
Hygiene
Acyclovir or Valacyclovir
Shingrix vaccine info?
0.5ml IM x 2 doses 2-6 months apart, more AE on second dose
Measles infectious period?
4 days before to 4 days after rash via droplet and airborne
S/Sx of measles?
Maculopapular rash, koplik spots which can cause subacute sclerosing panencephaltitis
Measles Tx?
Supportive care
S/Sx of mumps?
Parotitis, aseptic meningitis, encephalitis
Mumps Tx?
Supportive care
Tx of rabies?
PEP within 10 days
Prevent via vaccine IM x days 0, 7, and 21 or 28 days
Common coronavirus is the ___ most common cause of a cold
2nd