Microbiology 13 - Antivirals Flashcards
management of VZV
acyclovir PO/iv or valaciclovir PO (prodrug)
what type of drugs are acyclovir and valaciclovir? And what do they need for activation?
nucleoside analogues. They require viral thymidine kinase to be activated. They are essentially CHAIN TERMINATORS.
management of acyclovir resistant strains of VZV
Foscarnet or cidovofir
management of HSV encephalitis vs HSV meningitis
HSV encephalitis: emergency, manage empirically with IV aciclovir
HSV meningitis: self limiting
where does primary CMV virus stay latent?
in blood monocytes and dendritic cells and reactivated following immunosuppression
consequences of CMV in immunocompromised
BM suppression, pneumonitis, colitis, encephalitis , retinitis, hepatitis
histology finding characteristic of CMV
“Owl’s eyes” / inclusion bodies
Acyclovir - which herpes virus is this drug completely useless for and why?
CMV - this virus does not use thymidine kinase
antiviral treatment of CMV?
IV ganciclovir or PO valganciclovir
Major side effect of Ganciclovir? Which patients can this definitely not be used in?
BM suppression - do not use inBMT/HSCT/neutropaenic patients
which drug is used to treat CMV in BNT./HSCT patients?
IV foscarnet (nephrotoxic)
third line drug in treatment of CMV infection in immunocompromised
Cidofovir (nephrotoxic)
3 main strategies for treatment of CMV in transplant patients
Treat established disease: Ganciclovir and reduce immunosuppression
Prophylaxis: valganciclovir (in SOT)
Pre-emptive therapy: Foscarnet in HSCT/BMT patients
what is a major complication of EBV in immunocompromised e.g. post transplant?
Post-transplant lymphoproliferative disease, predisposes to lymphoma
Lymphoproliferative disease is associated with which viral infection? How is it treated?
EBV
Tx: rituximab + reduce immunosuppression
