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M2. Pharm Antiviral
Zanamivir (Relenza) and Oseltamivir (Tamiflu)
Indications
Influenza A and B
Treatment and Prophylaxis
Mechanism
Inhibits Release of New Virus
Inhibits Influenza Neuraminidase
1 min
Ribavirin
Mechanism
Hypermutation in RNA Viruses
Inhibits Inosine Monophosphate Dehydrogenase
Indications
Hepatitis C
Viral Hemorrhagic Fevers
Respiratory Syncytial Virus (RSV)
Side Effects
Hemolytic Anemia
Teratogen
1 min
Hepatitis A
Characteristics
Picornavirus
4 Week Incubation Period
Fecal-oral
Day Care Centers
Travel to Developing Countries
Signs and Symptoms
Usually Asymptomatic
Acute Disease
Jaundice
Fever
Vomiting
2 mins
Hepatitis B Virus Disease
Can turn chronic
< 10% of adults become chronic carriers
90% of newborns become chronic carriers
Cirrhosis
Hepatocellular carcinoma
Membranous Glomerulonephritis
Polyarteritis nodosa
Serum sickness like syndrome
2 mins
Hepatitis B Virus Characteristics
Hepadnavirus
Enveloped
Circular
Partially Double-stranded DNA
Has Reverse Transcriptase
IV Drug Use
Sex
Maternal Fetal Routes
3 Month Incubation Period
2 mins
Hepatitis C
Characteristics
Enveloped
RNA Virus
Flavivirus
Icosahedral
SS positive Linear
Clinical Features
Most Cases are Due to IV Drug Use
Turns to Chronic Hepatitis in Over 70% of Cases
Cirrhosis
Hepatocellular Carcinoma
Most Common Indication for Liver Transplantation
Associated With Type I MPGN
Porphyria Cutanea Tarda
2 mins
Herpes Simplex Virus (HSV)
Characteristics
Enveloped
Double Stranded DNA
Linear
Signs and Symptoms
Type 1 HSV
Gingivostomatitis
Keratoconjunctivitis
Encephalitis of Temporal Lobes
Latent in Trigeminal Ganglia
Type 2 HSV
Genital Vesicles
Neonatal Herpes
TORCHES
Latent in Sacral Ganglia
Diagnosis
Tzanck Test
Multinucleated Giant Cells
Cowdry A Inclusions
Treatment
Acyclovir
2 mins
Ganciclovir
Indications
Cytomegalovirus (CMV)
Immunocompromised
Mechanism
Guanosine Analog
Disrupts DNA Synthesis
Inhibits Viral DNA Polymerase
Side Effects
Hematologic Effects
Nephrotoxicity
1 min
Cidofovir
Indications
CMV Retinitis
Acyclovir-Resistant HSV
Mechanism
Inhibits Viral DNA Polymerase
Side Effects
Nephrotoxicity
Administer with Probenecid and IV Saline
1 min
Foscarnet
Indications
CMV Retinitis
Acyclovir-resistant HSV
Mechanism
Does Not Require Activation (by Viral Kinase)
Inhibits Viral DNA Polymerase
Pyrophosphate Analog
Resistance through Mutated DNA Polymerase
Side Effects
Nephrotoxicity
Electrolyte Abnormalities
Hypokalemia
Hypocalcemia
Hypomagnesemia
2 mins
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