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Updated: 10/1/2019

Anti-Virals

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Questions
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Evidence
2
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Videos / Pods
1
Topic
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  • Introduction
    • Drugs
      • HIV anti-viral medications or highly active antiretroviral therapy (HAART)
        • nucleoside analog reverse transcriptase inhibitors (NRTI)
        • non-nucleoside reverse transcriptase inhibitors (NNRTI)
        • fusion inhibitors
        • integrase inhibitors
        • protease inhibitors
      • HCV anti-viral medications
      • other anti-viral medications
    • Clinical use
      • viral infections
        • for HIV infections, regimen often consists of 3 drugs to prevent resistance: 2 NRTIs and an integrase inhibitor or protease inhibitor
          • increasingly, regimens are tailored to viral genomics and resistance patterns
        • for HCV infections, regimen also consists of multiple drugs to prevent resistance
      • HIV Highly Active Antiretroviral Therapy (HAART)
      • Drugs
      • Mechanism of Action
      • High Yield Adverse Effects
      • Abacavir (ABC)
      • Didanosine (DDL)
      • Emtricitabine
      • Lamivudine
      • Stavudine
      • Zidovudine (ZDV)
      • Tenofovir (a nucleotide rather than nucleoside)
      • NRTI
      • Bone marrow suppression
      • Peripheral neuropathy
      • Lactic acidosis
      • Anemia (ZDV)
      • Pancreatitis (DDL)
      • Drug hypersensitivity (ABC) (HLA-B*5701 positive patients)
      • ZDV can be used during pregnancy
      • Delavirdine
      • Efavirenz
      • Nevirapine
      • NNRTI
      • Drug rash
      • Liver toxicity
      • Vivid dreams (efavirenz)
      • Neurologic symptoms (efavirenz)
      • Contraindicated in pregnancy (efavirenz and delavirdine)
      • Atazanavir
      • Darunavir
      • Fosamprenavir
      • Indinavir
      • Lopinavir
      • Ritonavir
      • Saquinavir
      • Protease inhibitors, preventing maturation of new viruses
      • Hyperglycemia
      • Gastrointestinal upset
      • Cushing-like syndrome
      • Renal toxicity (indinavir)
      • Thrombocytopenia (indinavir)
      • Inhibits cytochrome P450 (ritonavir)
      • Dolutegravir
      • Elvitegravir
      • Raltegravir
      • Integrase inhibitors, inhibiting integration of viral genome into host cell chromosome
      • Increased serum creatine kinase
      • Enfuvirtide
      • Maraviroc
      • Fusion inhibitors
      • Enfuvirtide: inhibits viral entry by binding to viral gp41
      • Maraviroc: inhibits viral entry by binding CCR-5 on host T-cells, inhibiting its interaction with viral gp120
      • Injection site reactions (enfuvirtide)
      • Peripheral neuropathy (enfuvirtide)
      • Hepatotoxicity (maraviroc)
      • Griseofulvin
      • Disrupts mitosis via microtubule dysfunction
      • Especially targets keratin-containing tissues such as nails
      • Fungistatic
      • Teratogenic
      • Disulfiram-like reaction
      • Neurologic symptoms
        • confusion
        • headaches
      • Induces cytochrome P450
      • HCV Anti-Viral Medications
      • Drug
      • Mechanism of Action
      • High Yield Adverse Effects
      • Indications
      • Ribavirin
      • Guanine nucleotide synthesis inhibition
      • Hemolytic anemia
      • Teratogenic
      • RSV
      • HCV
      • Interferons
      • Glycoprotein analogs (normally synthesized by infected cells, as well as tumor cells)
      • Flu-like symptoms
      • Neutropenia
      • Myopathy
      • Depression
      • HBV
      • HCV
      • Kaposi sarcoma
      • Condyloma acuminatum
      • Ledipasvir
      • Viral phosphoprotein (NS5A) inhibitor, which disrupts viral replication
      • Fatigue
      • Headache
      • HCV
      • Simeprevir
      • HCV protease (NS3/4A) inhibitor, disrupting replication
      • Photosensitivity
      • Pruritus
      • Fatigue
      • Headache
      • HCV
      • Sofosbuvir
      • HCV RNA-dependent RNA polymerase (NS5B) inhibitor
      • Fatigue
      • Headache
      • Nausea
      • HCV
      • Other Anti-Viral Medications
      • Drugs
      • Mechanism of Action
      • High Yield Adverse Effects
      • Indications
      • Oseltamivir
      • Zanamivir
      • Inhibits neuraminidase, which results in decrease of progeny virus release
      • Gastrointestinal upset
      • Influenza A and B
      • Acyclovir
      • Famciclovir
      • Valacyclovir
      • Guanosine analogs and inhibits viral DNA polymerase
      • Specifically processed by HSV/VZV enzymes
      • Obstructive crystalline nephropathy which can lead to acute renal failure
        • hydration can prevent this
      • HSV
      • VZV
      • Ganciclovir
      • Valganciclovir
      • Guanosine analogs and inhibits viral DNA polymerase
      • Specifically processed by CMV viral enzymes
      • Bone marrow suppression
      • Renal toxicity
      • CMV
      • Foscarnet
      • Viral DNA and RNA polymerase inhibitor
      • HIV reverse transcriptase inhibitor
      • Renal toxicity
      • Seizures secondary to electrolyte abnormalities
      • Acyclovir-resistant HSV
      • Ganciclovir-resistant CMV
      • Viral DNA polymerase inhibitor
      • Renal toxicity
        • coadminister with probenecid and hydration
      • CMV retinitis
      • Acyclovir-resistant HSV

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Questions (1)

(M1.MC.15.75) A thymidine kinase-deficient varicella-zoster virus strain has been isolated at a retirement home. Many of the elderly had been infected with this strain and are experiencing shingles. Which of the following would be the best antiviral agent to treat this population?

QID: 106859

Acyclovir

22%

(36/165)

Famciclovir

19%

(31/165)

Ganciclovir

16%

(26/165)

Cidofovir

41%

(68/165)

Amantadine

2%

(3/165)

M 3 D

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Evidence (2)
VIDEOS & PODCASTS (1)
EXPERT COMMENTS (3)
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