Viral Infections Flashcards
Influenza (Flu)
Neuraminidase Inhibitors:
- Give within 48 hours of symptom onset
- WARNING: neuropsychiatric events
Oseltamivir (Tamiflu)
- Treatment= BID x 5 days
- Prophylaxis= QD x 10 days
Zanamivir (Relenza Diskhaler)
- Treatment=2 inhalations BID x 5 days
- Prophylaxis=2 inhalations QD x 10 days
- DO NOT USE with breathing problems
Endonuclease inhibitor:
Baloxavir marboxil (Xofluza)
- single dose
COVID-19
Similar symptoms to flu with addition of loss of taste or smell
Diagnosis with PCR
Treatment:
Symptom management
Remdesivir (Veklury)
Nirmatrelvir/ritonavir (Paxlovid)
Tocilizumab
Herpes Virus
HSV-1 = oropharyngeal
HSV-2 = genital
Treatment is dosed based on IBW
Herpes Simplex Labialis (cold sore):
Topical treatment:
- Docosanol (Abreva [OTC]): 5x QD until healed
- Acyclovir (Zovirax): 5x QD for 4 days
Systemic treatment:
- Acyclovir: 5x QD or TID
- Valacyclovir: BID or QD
Genital Herpes:
Treatment must be initiated within 1 day of lesion onset
Initial treatment = 7-10 days
Recurrence = ~5 days
Chronic suppression = BID or QD
Invasive HSV infection:
Viral encephalitis
Treatment= IV acyclovir 10mg/kg/dose Q8H 14-21 days
Varicella Zoster Virus + Herpes Zoster
Varicella (chickenpox) in childhood and recurrence in adulthood is herpes zoster (shingles)
Rash is very distinct:
- blisters in a band, unilaterally
Initiate therapy within 72 hours of rash onset
For pain:
- Lidoderm patch
- Neuropathic medications, NSAIDs, opioids
5-10% have postherpetic neuralgia (PHN)
Treatment:
- Acyclovir 5x QD for 7 days
- Valacyclovir TID for 7 days
- Famciclovir TID for 7 days
Cytomegalovirus
Occurs in immunocompromised (opportunistic infection)
Causes retinitis, colitis, esophagitis
Treatment:
- Ganciclovir or Valganciclovir:
— causes myelosuppression and is teratogenic
- Foscarnet or Cidofovir:
— can cause renal impairment
— reserved for refractory cases
Epstein-Barr Virus
Commonly known as “mono”
Spread through bodily fluids, and kissing
There is no treatment; it is self-resolving within 2-4 weeks
