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Therapeutics 3 > Influenza > Flashcards

Influenza Flashcards

1
Q

What are the antigenic changes of influenza A?

A
  • antigenic drift (minor changes in the viral surface antigens, point mutations in the gene segment, may result in an epidemic)
  • antigenic shift (major change in one or both surface antigens, due to exchange of gene materials between influenza viruses, may result in worldwide pandemic)
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2
Q

What is the timeline of symptom onset and viral shedding of influenza?

A
  • incubation period is typically 1-4 days (2 day average)
  • viral shedding may occur 12-24 hours before onset of symptoms
  • viral shedding peaks at day 2-3
  • viral shedding may persist for 5-7 days
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3
Q

What is the clinical presentation of Influenza?

A
  • fever
  • dry cough
  • sore throat
  • rhinorrhea
  • nasal congestion
  • headache
  • myalgias
  • fatigue
  • vomiting and diarrhea
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4
Q

What patient population is at high risk for severe disease from an influenza infection?

A
  • children aged 6-59 months (highest risk <2 years old)
  • adults 50+ years old
  • patients with chronic medical conditions
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5
Q

What complications may occur due to an influenza infection?

A
  • bacterial pneumonia
  • sinus infections
  • acute otitis media
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6
Q

What patients should recieve antiviral treatment for influenza?

A
  • hospitalized patients with confirmed or suspected influenza
  • outpatients with confirmed or suspected influenza with severe, complicated, or progressive illness
  • pt with higher risk of complications
  • children < 2 years old and adults 65+ years old
  • pregnant women and those within 2 weeks postpartum
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7
Q

What is the spectrum of action of neuraminidase inhibitors?

A

influenza A and B

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8
Q

What is the duration of therapy for Zanamirvir?

A

5 days

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9
Q

What is the duration of therapy of Oseltamivir?

A

5 days

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10
Q

What is the duration of therapy of Permivir?

A

1 dose

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11
Q

What is the dosing of Zanamivir?

A

2 inhalations BID

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12
Q

What are the adverse effects of Zanamivir?

A

headache, cough, throat discomfort, bronchospasms, sinusitis, dizziness, skin reactions, rare nervous system effects

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13
Q

What is the mechanism of action of neuraminidase inhibitors?

A

inhibition of neuraminidase enzyme -> preventing the budding of new virus

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14
Q

What drugs are neuraminidase inhibitors?

A
  • zanamivir
  • oseltamivir
  • peramivir
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15
Q

What is the dosing of Oseltamivir?

A

one tablet PO BID

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16
Q

What are the adverse effects of Oseltamivir?

A

headache, cough, throat discomfort, bronchospasms, sinusitis, dizziness, skin reactions, rare nervous system effects

17
Q

What is the dosing of Peramivir?

A

1 IV infusion over 15-30 minutes

18
Q

What are the adverse effects of Peramivir?

A

diarrhea, skin reactions, rare nervous system effects

19
Q

What is the mechanism of action of Xofluza (baloxavir marboxil)?

A

inhibits endonuclease activity of selective polymerase acid (PA) protein -> prevents virus replication

20
Q

What is the spectrum of action of Xofluza (baloxavir marboxil)?

A

influenza A & B

21
Q

What the dosing of Xofluza (baloxavir marboxil)?

A

single oral tablet dose of 40mg or 80mg based on weight
- 40 kg to < 80 kg= one 40mg dose
- 80+ kg= one 80mg dose

22
Q

What are special pharmacokinetic considerations of Xofluza (baloxavir marboxil)?

A

prodrug with a Vd of 1180L (use TBW for dosing)

23
Q

Which influenza vaccines are non egg based?

A

ccIIV3 and RIV3

inactivated vaccines (not live attenuated)

24
Q

At what age can patients begin to obtain influenza vaccines?

A

6 months

25
Q

What are the influenza vaccine recommendation for patients 65+ years old?

A
  • high dose inactivated influenza vaccine
  • recombinant influenza vaccine (RIV3)
  • adjuvanted inactivated influenza vaccine (aIIV3)
26
Q

When would the live attenuated vaccine (LAIV3) be indicated?

A
  • healthy, non-pregnant age 2-49 years old
  • people in contact with high risk groups, healthcare personal

option for individuals with egg allergy

27
Q

When would the IIV vaccine be indicated?

A
  • age 6+ months
  • pregnant women and immunocompromised patients

option for individuals with egg allergy

28
Q

When would the RIV vaccine be indicated?

A
  • age 18+ years
  • pregnant women and immunocompromised patients

option for individuals with egg allergy

29
Q

When would the ccIIV vaccine be indicated?

A
  • age 6+ months
  • pregnant women and immunocompromised patients

option for individuals with egg allergy

30
Q

What is an important contraindication of live attenuated influenza vaccine (LAIV3)?

A

antiviral medication use in recent days

Therapeutics 3 (14 decks)

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