Treatment of Viral Pneumonia Flashcards
Influenza A and B
Oseltamivir (PO)
Zanamivir (Inhalation)
**Get flu vaccine to prevent.
Influenza A
Amantadine (PO)
Rimantadine (PO)
**Get flu vaccine.
RSV
Ribavirin (inhalation, IV)
**Palivizumab (IM) for prevention.
Adenovirus
Cidofovir (IV)
**Vaccine for Types 4 and 7
Rhinovirus
- *No Treatment
* *Alfa interferon (intranasal) and ribavirin (off label) for prevention
Enteroviruses
No Treatment or Prevention
Human Metapneumovirus
Ribavirin (IV)
Hantavirus
Ribavirin (IV)
Varicella-Zoster
Acyclovir (IV)
Valacyclovir (IV)
**VZ Vaccine
MOA of Acyclovir
Inhibition of viral DNA synthesis via DNA polymerase inhibition.
MOA of Amantadine
Inhibition of viral entry or uncoating.
MOA of Cidofovir
Inhibition of viral DNA synthesis via DNA polymerase inhibition.
MOA of Oseltamavir
Inhibition of release of flu virus from host cell.
MOA of Ribavirin
Inhibition of viral nucleic acid synthesis.
MOA of Rimantadine
Inhibiton of viral entry or uncoating
MOA of Valcyclovir
Prodrug of acyclovir.
Inhibition of viral DNA synthesis via DNA polymerase inhibition.
MOA of Zanamivir
Inhibiton of release of flu virus from infected cell.
Metabolism of Acyclovir
Viral cells transform it to its active triphosphate form
Systemically elimination unchanged by glomerular filtration and tubular secretion.
Metabolism of Amantadine
Systemically elimination by glomerular filtration and tubular secretion.
Metabolism of Cidofovir
Metabolized by pyrimidine nucleoside monophosphate kinase to mono and then diphosphate analogs then finally to monophosphate choline.
Systemically elimination by glomerular filtration and tubular secretion.
Metabolism of Oseltamavir
HEPATICALLY metabolized to the corboxylate active form of the drug.
Systemic elimination via glomerular filtration and tubular secretion.
Metabolism of Ribavirin
Undergoes NON CYP metabolism in nucleated cells with systemic elimination of drug and its products in urine.
Metabolism of Rimantadine
Extensive hepatic metabolism with renal elimination of drug and metabolites.
Metabolism of Valcyclovir
Converted to acyclovir by first pass metabolism.
Systemic elimination by glomerular secretion and tubular secretion.
Metabolism of Zanamivir
Renally eliminated unchanged.
Toxicity of Acyclovir
Headache, nausea, elevated hepatic enzymes, nasopharyngitis, NEUTROPENIA.
- *MAINTAIN HYDRATION to prevent renal precipitation.
- *Use caution in renal impairment and with renotoxic drugs.
Toxicity of Amantadine
Neurological effect, Nausea, ORTHOSTATIC HYPOTENSION.
**Contraindicated in glaucoma and breast feeding.
Toxicity of Cidofovir
Neurological, Hematological, and tubular damage.
***Black Box Warning for renal impairment.
Toxicity of Oseltamavir
Minimal adverse effect.
Potential for fatal neuropsychiatric effects in flu patients.
Rare serious skin rash.
Toxicity of Ribavirin
Fatigue, headache, nausea, myalgia, fever.
**BlackBox Warning for hemolytic anemia and M/F teratogenicity.
Toxicity of Rimantadine
Minimal
Toxicity of Valcyclovir
Headache, nausea, elevated hepatic enzymes, nasopharyngitis, NEUTROPENIA.
- *MAINTAIN HYDRATION to prevent renal precipitation.
- *Use caution in renal impairment and with renotoxic drugs.
Toxicity of Zanamivir
Headache, tonsil/throat pain, cough, viral infection,
***Not to be used with underlying pulmonary disease due to fatal bronchospasm.
