Exam 4 - Tieman non-antiretroviral antivirals (study)

Question 1

most common type of infection for HSV-1

Answer 1

oral mucosa

Question 2

most common type of infection for HSV-2

Answer 2

genital mucosa

Question 3

HSV-1 presentation

Answer 3

-‘cold sore’ around mouth that can be transferred around the body
-sx present like most infections, first time most severe
-in sensory ganglia

Question 4

HSV-2 presentation

Answer 4

-bumps and blisters around genitals or anus
-in sacral ganglia

Question 5

HSV-1 and HSV-2 can cause which type of infections?

Answer 5

CNS (mostly HSV-1)

Question 6

acyclovir SE:

Answer 6

oral: HA
IV: nephrotox. (reversible), thrombophlebitis
both: neurotox

Question 7

HSV encephalitis dose

Answer 7

10mg/kg IV q8h x 2-3 weeks (AdjBW)
-hefty dose, wathc for nephrotox.

Question 8

famciclovir SE

Answer 8

HA
NVD
acute renal failure (dose adjust if pt has renal dysfxn)

Question 9

VZV is where in body?

Answer 9

sensory nerve ganglia

Question 10

CMV severe complications

Answer 10

affects eyes, can even cause end organ damage

Question 11

ganciclovir facts

Answer 11

renal dose adjust
SE: bone marrow suppression (reversible)
used for CMV retinitis, esophagitis, colitis, pneumonitis, neurologic disease

Question 12

valganciclovir facts

Answer 12

more bioavailable than ganciclovir
used for CMV retinitis and prevention of CMV disease in transplant pts

Question 13

letermovir facts

Answer 13

-inhibits pUL56 subunit of viral terminase complex of CMV
-used in CMV
-end result: inihbitions of CMV replication and prevention of CMV infection
-IV form contains hydroxypropyl betadex which is highly nephrotoxic
-lots of DI

Question 14

letermovir AE

Answer 14

NVD
peripheral edema
cough
HA
fatigue
ab pain

Question 15

letermovir used for:

Answer 15

prophylaxis of CMV infection and disease in adult CMV seropositive recipients of aan allogeneic HSCT

Question 16

letermovir CYP3A4 inhibitor or inducer?

Answer 16

inhibitor

Question 17

foscarnet considered more what type of therapy?

Answer 17

backup
-does not rqr phophorylation, not prodrug
-used in case of resistance

Question 18

foscarnet facts

Answer 18

only available IV
nephrotox.

Question 19

foscarnet uses

Answer 19

CMV retinitis
resistant HSV and VZV

Question 20

NA inhibitors

Answer 20

zanamivir (inhaler)
oseltamivir (oral)
peramivir (IV)

Question 21

when to tx with NAi

Answer 21

no more than 2 days after sx start

Question 22

zanamivir AE

Answer 22

bronchospasms

Question 23

lowest age for oseltamivir

Answer 23

2 weeks old

Question 24

lowest age for zanamivir

Answer 24

7 years old
5 years old if using prophylactically
do not use in asthma/COPD pts

Question 25

peramivir facts

Answer 25

-hypersensitivity rxn may occur, but rare -less cross resistance seen

Question 26

baloxavir marboxil considerations

Answer 26

-inhibits polymerase acidic (PA) endonuclease which leads to inhibition of mRNA synthesis and viral replication -avoid co-admin w dairy products (calcium) -do not admin w live attenuated flu vaccine -AE rare