ID-III: Antivirals

Question 1

How do you diagnose flu

Answer 1

Antigen detection tests
Rapid nasopharyngeal swab

Question 2

Sx of flu

Answer 2

Fever, chills ,fatigue, myalgia

Question 3

Age for seasonal flu vaccine

Answer 3

≥6 months

Question 4

Strains that are targeted by neuraminidase inhibitors

Answer 4

A and B

Question 5

When is neuraminidase inhibitor initiated

Answer 5

Started within 48 hrs of illness onset

Question 6

Formulations of neuraminidase inhibtiors

Answer 6

Oseltamivir: PO
Zanamivir: IN
Peramivir: Inj

Question 7

How does baloxavir different from other flu meds

Answer 7

One time dose that is given 48 hrs of sx onset

Question 8

Dose of Tamiflu

Answer 8

75 mg BID for 5 days

Question 9

ADR of Tamiflu

Answer 9

Neuropsychiatric events
HA, N, Vomiting

Question 10

ADR of Zanavir

Answer 10

Neuropsychiatric events
Bronchospasm (avoid in asthma and COPD)

Question 11

Baloxivir

Answer 11

Xofluza

Question 12

How is COVID spread

Answer 12

Respiratory droplets

Question 13

Diagnosis of COVID

Answer 13

PCR nasopharyngeal swab

Question 14

First line for COVID

Answer 14

Supportive care

Question 15

Meds for COVID

Answer 15

Paxlovid (Nirmatrelvir/Ritonavir)
IV Remdesivir (Veklury)
PO Molnupirivir (Lagevrio)

Question 16

What is the difference between herpes strain

Answer 16

HSV1: oropharygeal
HSV2: genital

Question 17

Antivirals for HSV and Varicella Zoster

Answer 17

Acyclovir
Valacyclovir
Famiciclovir

Question 18

ADR of Antivirals for HSV and Varicella Zoster

Answer 18

Caution in renal impairment, the elderly, and those receiving nephrotoxic drug

Question 19

How do you prevent acyclovir from damaging kidneys

Answer 19

Infuse over 1 hr and maintain adequate hydration to reduce renal tubular damage

Question 20

Dosing of acyclovir

Answer 20

IBW including obese patients

Question 21

Conversion of acyclovir to valacyclovir

Answer 21

5 mg/kg IV acyclovir = 1000 mg PO valacyclovir

Question 22

When is the optimal time to take medicine for cold sores

Answer 22

Prodrome (sx that occur before the lesion appears): itching, tingling, soreness

Question 23

Topical tx for cold sores? Dosing

Answer 23

Docosanol (Abreva): 5 times daily at first sign of outbreak

Acyclovir (Zovirax): 5 times daily for 4 days

Question 24

What is the difference between dosing of recurrence and chronic suppression for Cold sores

Answer 24

Chronic suppression is dosed lower and less frequently

Question 25

When is medicine initiated for genital herpes

Answer 25

Prodrome period or within 1 day of lesion onset

Question 26

What are the preferred agents for genital herpes

Answer 26

Acyclovir Valacyclovir

Question 27

What are the benefits of using PO Valacyclovir over PO Acyclovir

Answer 27

Reaches higher concentrations and less frequent dosing to enhance adherence

Question 28

What is given for HSV viral encephalitis?

Answer 28

IV acyclovir 10 mg/kg/dose Q8H for 14-21 days 5 mg/kg/dose Q8H for other infections

Question 29

Sx of shingles rash

Answer 29

Itchy, tingling, painful, unilateral

Question 30

Pain medications of shingles

Answer 30

Topical: Lidoderm Neuropathic: Pregabalin, gabapentin, duloxetine, TCA NSAIDs or opioids

Question 31

What is another name for chronic pain caused by shingles

Answer 31

Postherpetic neuralgia

Question 32

Who is indicated for Shingrex

Answer 32

≥50 YO ≥19 YO who are immunocompromised

Question 33

Duration of shingles regimen

Answer 33

7 days

Question 34

Sx of CMV infection

Answer 34

Reitinitis, colitis, esophagitis

Question 35

Treatment of choice for CMV

Answer 35

Ganciclovir Valganiciclovir Foscarnet and cidofovir: refractory

Question 36

How should ganaciclovir be prepared

Answer 36

Reconstitute with sterile water not bacteriostatic water

Question 37

How should valganacilovir be stored

Answer 37

PO solution: refrigerate and discard after 49 days

Question 38

BBW of ganaciclovir and valganacciclovir

Answer 38

Myelosuppression

Question 39

BBW of foscarnet

Answer 39

Renal impairment (prehydration recommended) Status epileptics due to electrolyte imbalances

Question 40

Indication for letermovir

Answer 40

CMV prophylaxis

Question 41

Dosing og letermovir

Answer 41

IV vehicle (hydroxypropyl betadex) can accumulate if CrCl <50

Question 42

How is EBV transmitted?

Answer 42

Bodily fluid, primarily saliva and can spread with kissing