CMV

Question 1

Cytomegalovirus

Answer 1

Opportunistic infection: healthy immune system can keep virus from causing illness
- most people experience no or mild symptoms

Severe disease occurs in: fetal development and can cause congenital abnormalities

Immunocompromised: CMV retinitis occurs in small portion of AIDS patients

Question 2

Letermovir

Answer 2

non-nucleoside

Question 3

Letermovir MOA

Answer 3

Inhibits pUL56 subunit of viral terminase complex of CMV–>prevents cleavage of concatemeric DNA into monomeric genome length DNA interfering with viral DNA processing and packaging into procapsids–>inhibits CMV replication and prevention of CMV

Question 4

Letermovir spectrum

Answer 4

CMV prophylaxis

Adult allogenic hematopoietic stem cell transplant for CMV

Question 5

Letermovir PK

Answer 5

Oral bioavailability is 94%
High protein bound 99%

Renally eliminated via glomerular filtration
- no dosage adjustment for CrCl < 10 mL/min
- if CrCl < 50 mL/min–>monitor SCr

Question 6

Letermovir SE

Answer 6

N/V/D, abdominal pain
Peripheral edema

Question 7

Letermovir drug interactions

Answer 7

CYP3A4 inhibitor and OATP 1B1/3

Question 8

Letermovir resistance

Answer 8

NONE

Question 9

HSV1/2 spectrum of activity

Answer 9

Acyclovir
Valacyclovir
Famciclovir
Ganciclovir
Valganciclovir
Foscarnet

Question 10

VZV spectrum of activity

Answer 10

Acyclovir
Valacyclovir
Famciclovir
Ganciclovir
Valganciclovir
Foscarnet

Question 11

CMV

Answer 11

Ganciclovir
Valganciclovir
Foscarnet
Letermovir

Question 12

EBV spectrum of activity

Answer 12

Ganciclovir
Valganciclovir
Foscarnet