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Dermatology > Tx of viral skin infections > Flashcards

Tx of viral skin infections Flashcards

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Dermatology Board Prep flashcards
1
Q

topical drugs move in 3 ways to reach their target

A
  1. transcellularly
  2. paracellularly
  3. via the appendages (hair follicles)
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2
Q

which drugs can be given PO only (3)

A

famciclovir, valacyclovir, valganciclovir

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3
Q

name the drugs that can be given IV only (2)

A

cidofovir, foscarnet

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4
Q

name the drugs that can be given IV/PO (2)

A

ganciclovir, acyclovir

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5
Q

which skin condition requires immediate in hospital IV acyclovir

A

dermatitis herpatiformes

(HSV infection on top of atopic dermititis

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6
Q

which drugs are pro drugs

A

valacyclovir–> acyclovir
valganciclovir–> ganctyclovir
famciclovir–>penciclovir

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7
Q

tx for pox family viruses (1)

A

cidofovir

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8
Q

Tx for varicella zoster (shingles) (3)

A

acyclovir, valacyclovir, famcivlovir,

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9
Q

tx for varicella chicken pox (2)

A

acyclovir, valacyclovir

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10
Q

tx for HHV-6 (4)

A

cidofovir, foscarnet, ganciclovir, valganciclovir

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11
Q

tx for HHV-7 (1)

A

cidofovir

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12
Q

tx for HHV-8 (aka KSHV) (4)

A

cidofovir, famciclovir, ganciclovir, valacyclovir

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13
Q

tx for HHV-8 infection*??

A

ganciclovir, valganciclovir

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14
Q

used to treat herpes labialis

A

penciclovir–> a metabolite of famciclovir

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15
Q

acyclovir used to treat

A

varicella zoster and varicella chicken pox

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16
Q

cidofovir usewul against

A

pox viruses, HHV6, 7 and 8 (not active)

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17
Q

famciclovir used to treat

A

varicella zoster, HHV8 (not active)

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18
Q

foscarnet used to treat

A

HHV-6

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19
Q

gaciclovir used to treat

A

HHV6, HHV8, HHV8 active

20
Q

valacyclovir used to treat

A

Varicella zoster, varicella chicken pox, HHV8 (not active)

21
Q

Valganciclovir used to treat

A

HHV-6, HHV 8 active

22
Q

describe herpes virus

A

linear, DNA, enveloped, icosahedral

23
Q

herpes virus life cycle

A

attachment, entry, uncoating, localisation to the nucleus
>immediate early proteins transcribed
>DNA replication
>bulk of genes (late genes) exressed
>late proteins incorporated into forming new virion progeny
>release/lysis

24
Q

name the immediate early genes

A

thymidine kinase

DNA polymerase

25
Q

drugs that inhibit DNA polymerase after transcription of the Immediate early gene products

A

foscarnet, ganciclovir, acyclovir, valacylovir, valganciclovir, cidofovir
*i think its just all of them

26
Q

DNA viruses translate mRNA into protein using….

A

host ribosomes

27
Q

how does acyclovir and valacyclovir work in the nucleus

A

viral thymidine kinase (an immediate early gene product)–> takes it from AMP–ATP..then it is preferentially encorporated into the gorowing DNA replicating chain…the chain is then terminated

28
Q

why does acyclovir cause chain termination

A

lacks the 3’ oh group needed for addition of new subunit

29
Q

ganciclovir/ valganiclovir have what difference from vala and acyclovir

A

they HAVE the 3’ OH group…so further DNA synthesis is possible once encorporated

30
Q

foscarnet acts via

A

pyrophosphate binding site of viral DNA polymerase (a immediate early product) AS WELL AS REVERSE TRANSCRIPTASE–> prevents celavage of pyrophosphate (Pi-Pi) from nucleotide triphosphate–> stalling further primer template extension
*stuck in the PPP form–> needs to be P form)

31
Q

which drugs competitively inhibit viral DNA polymerase; compete with dGTP for incorporation into viral DNA

A 
Acylovir
valacyclovir
ganciclovir
valganciclovir
famciclovir
32
Q

Cidofovir MOA

A

competitively inhibit viral DNA polymerase; compete with dCTP for incorporation into viral DNA

33
Q

KINASE DEFICIENT viral strains (not encoding a thymidine kinase) are resistant to which drugs

A
  • drugs that require activation and triple phosphorylation to their active products
    1. Acyclovir
    2. Valacyclovir
    3. Famciclovir
    4. ganciclovir
    5. Valaganiclovir
34
Q

drugs that will work on kinase deficient strains

A

cidofovir
foscarnet
*administered in their active state, do not require phosphorylation to be active

35
Q

metabolism for all of these drugs

A

little metab
renally eliminiated
dose adjustment needed if renal failure..if not all can cause renal failure

36
Q

lest side effects and best tolerated anti-viral

A

famcivlovir

37
Q

ADE’s for acyclovir and valacylvovir

A

neurotoxicity and seizures

38
Q

ADE’s for cidofovir

A

nephrotoxicity

minitor creatinine and urinary protein

39
Q

drug that requires probenacid prophyllaxis and normal saline

A

cidofovir

40
Q

ADE’S FOR FAMCICLOVIR

A

NONE

41
Q

ade’s for foscarnet

A

electrolyte imbalance

chelate Calcium ions

42
Q

ADE’s for gancilclovir and valnagciclovir

A

anemia, leukopenia, neutropenia, pancytopenia, thrombocytopenia, teratogen

43
Q

proven teratogens

A

ganciclovir

valganciclovir

44
Q

which drugs will have cross reactive hypersensitivity

A 
acyclovir
famciclovir
ganciclovir
valacyclovir
valganciclovir
45
Q

treating HHV6 with Valganciclovir or Ganciclovir->and have a hypersensitivty reaction-> can switch to

A

cidofovir or foscarnet

46
Q

treating HHV-8 (not active) with Fam,Gan or Val and have hypersensitivity reaction…can switch to

A

cidofovir– only thing effective and non-allergic

Dermatology (12 decks)

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