SARS-COV-2 Flashcards
How does the SARS-COV-2 nasal vaccine work?
iNCOVACC
Live attenuated nasal vaccine containing modified champanzee adenovirus and sars-cov-2 RNA encoding full length spike domain to generate broadly neutralising antibodies and mucosal immunity
Which COVID therapeutics can not be used in patients with egfr <30
NEEDS CORRECTING
Remdesivir (UPDATE this can be given at any renal stage)
(most common advserse reaction is derranged LFTs)
(dose is weight related: if over 40kg give 200mg day one, then 100mg daily after, duration is 5-10 days if they have pneumonia, 3 days if they do not)
Paxlovid (Nirmatrelvir/ritonavir)
(Dysguesia common SE, and diarrhoea)
(dose is 300 mg nirmatrelvir (two 150 mg tablets) with 100 mg ritonavir (one 100 mg tablet) all taken together orally twice daily for 5 days
Baracitanib
Only things that are in guidelines for those with egrf <30
Sotrovimab
*Remdesivir can potentially be given for those on dialysis
Molnuprivir has not been studies, but not contra-indicated per se
https://ukkidney.org/sites/renal.org/files/UK%20RPG%20COVID%20Treatments%20for%20non-hospitalised%20kidney%20patients%2011.02.22.pdf
Which monoclonals used for COVID are JAK inhibitors
How are they administered and for how long?
Baracitinib, roxulimitnib tofacinib (Baracitinib is preferred and most studied)
PO medication for 14 days
baracitinib indications include:
COVID confirmed, needing oxygen, COVID pneumonia, on dex already
Don’t give in renal or hepatic failure
Can give in combination with IL-6 inhibtors
https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2022/11/C1708-interim-clinical-commissioning-policy-baricitinib-for-patients-hospitalised-due-to-covid-19-nov-22.pdf?UNLID=91735507720231223124249#:~:text=JAK%2Dinhibitors%20are%20thought%20to,patients%20with%20severe%20COVID%2D19.
What is sotrovimab?
Monoclonal abs
(others in class are casirivimab/imdevimab and bebtelovimab)
Treatment should be started as soon as possible and within 7 days of symptom onset
