Pharm - Viral Shit Flashcards
What is the treatment for influenza A and B viruses? include route
Oseltamivir (PO)
Zanamivir (inhaled)
What drugs is used for influenza A only? include route
Amantadine and Rimantadine, both PO
What is the treatment for RSV? and route
Ribavirin (inhalation, IV)
what is the treatment for adenovirus? route
Cidofovir (IV)
what is the treatment for Rhinovirus?
none listed
what is the treatment of enteroviruses?
none (get fucked)
what is the treatment for human metapneumovirus
Ribavirin (IV)
what is the treatment for Hantavirus?
Ribavirin (IV)
what is the drug(s) for Varicella zoster virus? and routes
Acyclovir (IV)
Valcyclovir (PO)
Acyclovir MOA
inhibition of viral DNA synthesis (DNA polymerase inhibition)
Amantadine MOA
inhibition of viral entry or uncoating (M2 channel blocker)
Cidofovir MOA
inhibition of viral DNA synthesis (DNA polymerase inhibition)
Oseltamivir MOA
inhibition of release of influenza virus from infected cell (neuraminidase inhibitor)
Ribavirin MOA
inhibition of viral nucleic acid synthesis
Rimantadine MOA
inhibition of viral entry or uncoating (M2 channel inhibitor)
Valacyclovir MOA
pro-drug for acyclovir
Zanamivir MOA
inhibition of release of influenza from infected cell
Acyclovir metabolism to get activated - think activation by human or activation by virus
viral cells transform acyclovir to its active triphosphate form
Cidofovir metabolism to get activated - virus or human
metabolized via pyrimidine nucleoside monophosphate kinase (in the human) to mono- and then diphosphate analogs and finally to the monophosphate choline
Oseltamavir metabolism to get activated - virus or human
hepatically metabolized to the carboxylate active form of the drug
Ribavirin metabolism to get activated
undergoes non-CYP metabolism in nucleated cells
Valacyclovir metabolism to get activated
converted to acyclovir by 1st pass metabolism
in general, how are the antivirals eliminated?
renally
Toxicity of acyclovir? what pt group should you use caution in and what to do to prevent?
HA, nauseau, elevated hepatic enzymes, nasopharyngitis, neutropenia
use cautiously in renal impairment - maintain hydration to prevent renal precipitation
toxicity of Amantadine? what pt groups is it contraindicated in?
neurologic, nausea, orthostatic hypotension
contraindicated in narrow angle glaucoma and with breastfeeding
toxicity of Cidofovir and what important BBW does it carry?
neurologic, hematologic and tubular damage
BBW - renal impairment and toxicity
Oseltamavir toxicity, and potential fatal adverse effect
minimal adverse effects
potential for fatal neuropsychiatric adverse effects in flu patients; serious skin reaction reported rarely
toxicity of Ribavirin, and impt BBW
common - fatigue, HA, myalgia, nausea, fever
BBW - hemolytic anemia and M/F teratogenicity
toxicity of Rimantadine
minimal adv effects
toxicity of valacyclovir
same as acyclovir
toxicity of Znamivir and what important contraindication
HA, throat/tonsil pain, cough, viral infection
NOT to be used w/ underlying pulmonary disease - fatal bronchospasm
