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obligate cellular parasites composed of nucleic acid core and a pretein outer shell
viruses
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which viruses cause polio, colds, pneumonia, gastroenteritis, influenza, hepatitis, encephalitis, yellow fever, hemorrhagic fever, rubela, mumps, rabies, AIDS, Ebola
RNA
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which viruses cause cold sores, conjunctivitis, genital herpes, encephalitis, shingles, chickenpox, mononucleosis, hepatitis, small pox, warts, URI
DNA
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the most successful prophylaxis against viral disease
immunization
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what is the biggest problem with trying to get a vaccine for a virus
rapid viral mutation
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what must vaccines be to provide a response
sufficiently antigenic
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most common viral infection
cytomegalovirus
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virus most humans are exposed to
epstein-barr virus
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virus characterized by chicken pox
herpes varicell-zoster virus
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virus characterized by blisters and lesions
herpes simplex
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phosphonate anti-herpes agent
indicated for acyclovir resistant HSV-1&2 and varicella Zoster
injection - not a cure
watch for renal impairment
selective inhibition of pyrophosphate bonding site - specific DNA polymerase
foscarnet sodium - foscavir
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synthetic nucleoside anti-herpes agent
HSV-1&2
epstein-barr
oral, IV or topical
inhibits DNA polymerase and replication by being incorporated into DNA
dosage based on Creatinine clearance
acyclovir - zivirax
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prodrug form of the drug acyclovir
oral use only with rapid first-pass deesterification
valacyclovir HCL - valtrex
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synthetic nucleoside anti-herpes agent
only for use in CMV infections in immuno-compormised or transplant patients
known teratogenic - catergory C
MOA - 2 mechanisms, complete inhibition of DNA polymerase, DNA incorporation resulting in DNA chain termination
take with food
dose based on Crcl
ganciclovir - cytovene
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synthetic nucleoside anti-herpes agent
ophthalmic implant
vitrasert
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synthetic nucleoside anti-herpes agent
indicated for immunocompromised patients (not liver transplant)
prodrug ester of ganciclovir
MOA - 2 mechanisms - competitive inhibition of DNA polymerase, DNA incorporation resulting in DNA chain termination
valganciclovir HCL - valcyte
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synthetic nucleoside anti-herpes agent
ind - herpes labialis
moa - inhibits DNA polymerase following phosphorylation to the triphosphate
topical cream
peniciclovir - denavir
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synthetic nucleoside anti-herpes agent
ind - acute herpes zoster, genital herpes
prodrug form of penicilovir
oral use only
moa- inhibits DNA polymerase following phosphorylation to the triphosphate
can be taken without regard to meals
famciclovir - famvir
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synthetic nucleoside anti-herpes agent
ind - patients that have failed ganciclovir or fascarnet
injection only, must be co-administered with probenecid
moa- inhibits DNA polymerase following phosphorylation to the diphosphate
class C
cidofovir - vistide
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anti-herpes agent for oral and facial herpes simplex cold sores and lesions
10% cream for topical application
moa - inhibits viral replication of a number of lipid enveloped viruses
docosanol - abreva
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anti-sense anti-herpes agent
ind - CMV retinitis in immunocompormised patients
moa - antisense oligonucleotide
intravitreal injection only
no longer available in the USA
fomivirsen sodium - vitravene
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synthetic nucleoside topical opthalmic anti-viral
known as IDU
ind - herpes simplex keratitis
moa - resembles thymidine, incorporated into a pseudostructure
don't use with boric acid solutions, sensitivity to light
idoxuridine - dendrid, herplex
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synthetic nucleoside topical anti-viral
ind - keratoconjunctivitis
moa - interfers with DNA synthesis, not exactly known
stinging upon administration
trifluridine - viroptic
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synthetic nucleoside topical ophthalmic anti-viral
ointment
discontinued in the USA
vidarabine - vira-A
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anti-RSV
lyophillized powder for aerosol inhalation
infants and young children
accumulates in red cells
teratogenic
virazole
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anti-RSV agent
safety and efficacy has NOT been established for treatmetn of RSV disease
blocks a critical step in membrane fusion process
palivizumab - synagis
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treatment for Hep A
rest and avoid alcohol
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phosphonate nucleotide analog of adenosine used for HBV & HIV
moa - prodrug that inhibits HBV DNA polymerase
adefovit dipivoxil - hepsera
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unmodified beta-L enantiomer of thymidine
HBV for 16 yo and up
no known activity against HIV
competitve inhibition of thymidine 5'-triphosphate
telbivudine - tyzeka
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guanosine nucleotide
inhibits all three activities of HBV
no clinically relvant activity against HIV-1
must be taken on an empty stomach
entecavir - baraclude
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peptidomimetic for HCV
used in combination with peginterferon and ribavirin
compensated liver disease
moa inhibits serine protease
take with high fat meal
telaprevir - incivek
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peptidomimetic for HCV
used in combination with peginterferon and ribavirin
compensated liver disease
moa inhibits serine protease
take with high/low fat meal
boceprevir - victrelis
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anti-influenza agent
prophylaxis against influenza A
moa- uncoating
renally excreted
amantadine HCL - symmetrel
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anti-influenza agent
prophylaxis against influenza A
moa- uncoating
metabolized by the liver
prodrug substrate for p-glycoprotein not the substrate
rimantadine HCL - flumadine
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anit-influenza neuraminidase inhibitor
influenza A & B, symptomatic for less than 2 days
drug of choice in avian H5N1
moa - ethyl ester prodrug alters particle aggregation and release
oseltamivir phosphate - tamiflu
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anit-influenza neuraminidase inhibitor
influenza A & B, symptomatic for less than 2 days
useful in avian H5N1
moa - ethyl ester prodrug alters particle aggregation and release
zanamivir - relenza
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cleavage of this, by neuramidase facilitates the spread of new virus and increases pathogenicity
sialic acid
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IV only for H1N1
peramivir
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