Herpes Antivirals Flashcards
What class are Herpes antivirals
Pur/Pyr analogs
What are the Herpes antivirals
Acyclovir Ganciclovir Penciclovir Famciclovir Cidofovir Vidarabine Trifluridine Foscarnet
DOC HSV encephalitis
Acyclovir
DOC retinitis and prophylaxis
Gancyclovir
Immunocompromised with Keratitis, Keratoconjunctivitis
Vidarabine
DOC HSV Keratoconjunctivitis and recurrent epithelial keratitis
Trifluridine
CMV retinitis in immunocompromised
Foscarnet
How does Acyclovir work
Competes with dGTP
Chain termination
Inhibit viral DNAP
What does Acyclovir work on
HSV1, 2
VSV
EBV
Which form of Acyclovir has the highest f
Valacyclovir
When does Acyclovir accumulate
Renal failure
How do you prevent ARF with IV Acyclovir
Slow infusion and hydration
What is resistant to Acyclovir
CMV
When is Gancyclovir active
Post phosphorylation by VIRAL kinases
Gancyclovir AE
Myelosuppression
Neutropenia
Gancyclovir contraindication
Pregnancy
How is Gancyclovir resistance conferred
Decreased phosphorylation
What works via DNAP inhibition and DNA chain termination
Gancyclovir
Cidofovir
Penciclovir
Famciclovir
When is Cidofovir active
Post phosphorylation by HOST kinases
When do you give Cidofovir
CMV retinitis
Gancyclovir resistant HSV
Why do you give Probenecid with Cidofovir
Block renal secretion
Cidofovir AE
Nephrotoxic
How is Cidofovir Resistance conferred
DNAP mutation
What is Penciclovir for
Cold sores
What is Famciclovir for
Acute zoster
Genital herpes in immunocompromised
Needs 3 phosphorylations to be active
Acyclovir
Needs 1 phosphorylation by thymidine kinase
Penciclovir
Famciclovir
What is the relationship between Penciclovir
and Famciclovir
Fam is prodrug
Fam/Penciclovir AE
HA
Nausea
Diarrhea
How does Vidarabine act
Triphosphate form inhibits DNA synth
What do you give Vidarabine for
HSV
CMV
VZV
Vidarabine AE
Superficial punctate keratitis
Pain
Photophobia
Acyclovir resistant HSV, CMV
Foscarnet
Gancyclovir resistant CMV, VZV
Foscarnet
How does Trifluridane work
Triphosphate form incorporates into DNA causing fragmentation
Opthalmic ointments
Vidarabine
Trifluridine
Trifluridine AE
Irritation
Palpebral edema
Foscarnet AE
Nephrotoxic
Electrolyte disturbances
Anemia
CNS
How is Foscarnet resistance conferred
Point mut in polymerase
Does Foscarnet require phosphorylation
NO
What is Foscarnet an analog of
Pyrophosphate
What does Foscarnet do
Inhibit binding in viral DNAP