PHARM: Viral Pneumonia Flashcards
What is the treatment for Influenza A and B viruses?
Oseltamivir (PO)
Zanamivir (inhaled)
What is the treatment for Influenza A virus?
Amantadine (PO)
Rimantadine (PO)
What is the treatment for RSV?
Ribavirin (inhalational or IV)
What is the treatment for Adenovirus?
Cidofovir (IV)
What is the treatment for Rhinovirus?
none
What is the treatment for Enteroviruses?
none
What is the treatment for human metapneumovirus?
Ribavirin (IV)
What is the treatment for hantavirus?
Ribavirin (IV)
What ist he reatment for varicella-zoster virus?
Acyclovir (IV)
Valacyclovir (PO)
What is the MOA of acyclovir?
Inhibition of viral DNA synthesis (via polymerase inhibition)
How is acyclovir metabolized?
viral cells transform it into its active triphosphate form.
Systemic elimination unchanged by glomerular filtration and tubular secretion
What are the AEs of acyclovir?
Headache, nausea, elevated hepatic enzymes, nasopharyngitis, neutropenia, stay hydrated to prevent kidney problems
What is the MOA of amantadine?
inhibition of viral entry or uncoating
How is amantadine metabolized?
systemic elimination unchanged by glomerular filtration and tubular secretion
What are the AEs of amantadine?
Multiple: neurologic, nausea, and orthostatic hypotension
Contraindicated in narrow angle glaucoma and with breastfeeding
What is the MOA of cidofovir?
Inhibition of viral DNA synthesis (DNA polymerase inhibition)
How is cidofovir metabolized?
Metabolized via pyrimidine nucleoside monophosphate kinase to mono- and then diphosphate analong and finally to the monophosphate-choline
Systemic elimination by globular filtration and tubular secretion
What are the AEs of cidofovir?
BBW for renal impairment/toxicity
Also neurologic, hematologic, and tubular damage
What is the MOA of oseltamavir?
inhibition of release of influenza virus from infected cell
How is oseltamavir metabolized?
hepatic metabolism to the carboxylate active form of the drug
Systemic elimination by globular filtration and tubular secretion
What are the AEs of oseltamavir?
Minimal: potential for fatal neuropsychiatric adverse effects
Serious skin reactions (rarely)
What is the MOA of ribavirin?
inhibition of viral nucleic acid synthesis
How is ribavirin metabolized?
Undergoes non-CYP metabolism in nucleated cells with systemic elimination of drug and products in the URINE
What are the AEs of ribavirin?
BBW for hemolytic anemia and M/F teratogenicity
Others: fatigue, headache, myalia, nausea, fever
What is the MOA of rimantadine?
Inhibition of viral entry/uncoating
How is rimantadine metabolized?
Extensive hepatic metabolism with renal elimination of drug and metabolites
What are the AEs of rimantadine?
minimal
What is the MOA of valacyclovir?
Pro-drug for acyclovir
How is valacyclovir metabolized?
converted to acyclovir (and L-valine) by first pass metabolism. Systemic elimination (acyclovir) by glomerular filtration and tubular secretion
What are the AEs of valacyclovir?
same as with acyclovir
What is the MOA of zanamivir?
inhibition of release of influenza virus from infected cell
How is zanamivir metabolized?
renally eliminated unchanged
What are the AEs of zanamivir?
Contraindicated with underlying pulmonary disease (can lead to fatal bronchospasm)
Other: Headache, throat/tonsil pain, cough, viral infection
