Ocular Antivirals

Question 1

How do ocular antivirals attack the virus?

Answer 1

Inhibit viral DNA synthesis

Question 2

What are the main causes of eye infection?

Answer 2

HSV 1 and 2, HZV, CMV, EBV

Question 3

Vidabirine

Answer 3

treats HSV1 and 2, administered topically as an oitment, available only in compounding pharmacies, reserved for severe cases.

Question 4

Trifluridine (viroptic)

Answer 4

Topical, DOC for HSV keratitis. every 2 hours while awake. 6-7 days, must be refrigerated.
SE: burning, stinging, CPK from accumulation of percipitates in drops. Keratoconjunctivitis sicca: tx: with lubricating drops apply 5 mins after trifluridine to avoid dilution. INCREASE IOP so verify IOP before rxing. superior to vidaribine in effectiveness.

Question 5

Gancyclovir (zirgan)

Answer 5

made in 2010. gel form, can be admin IV in extreme cases, TX: HSV keratitis and off label on epidemic keratoconjunctivitis
cell specific. much gentler than trifluridine.

Question 6

Acyclovir (zovirax)

Answer 6

Active against HSV 1 and 2, HZV and CMV.
Admin: every 4-6 hours depending on severity, can also be admin topical and IV. suspension in Canada but not US. MUST initiate tx within 72 hours otherwise wont work.

Question 7

What drug is used on patients with recurring HSV infections?

Answer 7

Acyclovir (zovirax)