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RSM - 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
Influenza Virus
Characteristics
RNA Virus
Orthomyxovirus
Enveloped
Negative Sense
8 Segments
Helical
Hemagglutinin for Viral Entry
Neuraminidase for Virion Release
Genetic Shift
Reassortment of genome to cause major change
Genetic Drift
Minor Antigenic Mutations
Considerations
Reye Syndrome with Aspirin Use
Guillain-Barre Syndrome
3 mins
Acyclovir (Zovirax)
Mechanism
Guanosine Analog
Inhibits Viral Replication
Thymidine Kinase Activation
Indications
Herpes Simplex Virus (HSV)
Varicella Zoster Virus (VZV)
Side Effects (Oral)
Headache
GI Distress
Side Effects (IV)
CNS Toxicity
Nephrotoxicity (Crystalline Nephropathy)
Considerations
Prevents Recurrent Episodes
Slow IV Infusion
2 mins
Ganciclovir
Indications
Cytomegalovirus (CMV)
Immunocompromised
Mechanism
Guanosine Analog
Disrupts DNA Synthesis
Inhibits Viral DNA Polymerase
Side Effects
Hematologic Effects
Nephrotoxicity
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
Genital Herpes
Mechanism
Herpes Simplex Virus 1 and 2 (HSV)
Assessment
May Be Asymptomatic
Oral or Genital Lesions
Vesicles in Clusters
Pain
Flu-like Symptoms
Antiviral Medications
Acyclovir
Valacyclovir
Famciclovir
Considerations
Infectious During Recurrences
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
Varicella Zoster Virus (VZV)
Herpesvirus 3
Characteristics
Enveloped
Double Stranded DNA
Signs and Symptoms
Chickenpox
Pneumonia
Encephalitis
Trigeminal and Dorsal Root Ganglia
Shingles
Diagnosis
Tzanck Test
Multinucleated Giant Cells
Cowdry A Inclusion
Treatment
Acyclovir
2 mins
Cytomegalovirus (CMV)
Characteristics
Enveloped
Double Stranded DNA
Herpesvirus 5
Diagnosis
Non Heterophile Antibodies
Owl's eye inclusions
Signs and Symptoms
Congenital TORCH infection
Mononucleosis
Pneumonia
AIDS retinitis and esophagitis
Infection in transplant recipients
2 mins
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