Therapeutics - Viral 2

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kyleannkelsey
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286772
Filename:
Therapeutics - Viral 2
Updated:
2014-10-23 12:01:31
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Therapeutics Viral
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Therapeutics - Viral
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Therapeutics - Viral
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  1. What are the recommended Chemoprophylaxis drugs when the influenza subtype is unknown? Zanamivir
    Oseltamivir in combination with rimantadine
  2. What are the recommended Chemoprophylaxis drugs Influenza B?
    • Zanamivir
    • Oseltamivir
  3. When influenza viruses are circulating in the community, antiviral chemoprophylaxis can be considered for _______ persons during the ______ weeks after vaccination before an immune response to inactivated vaccine develops.
    • high risk
    • 2
  4. Antiviral chemoprophylaxis for influenza should be considered in high risk persons for whom the vaccine is___________, _______________ or ____________________.
    Contraindicated, unavailable, or expected to have low effectiveness
  5. Antiviral chemoprophylaxis should be considered in high risk, unvaccinated individuals when influenza activity has been ______________________________________.
    Documented in the community
  6. Antiviral chemoprophylaxis may be considered for_________________, __________________ and __________________, who are in close contact with high risk individuals during periods of influenza activity.
    Unvaccinated adults, including healthcare workers and children ≥ 1 year
  7. Antiviral chemoprophylaxis should be initiated in ALL non-infected family members, when ______________________ and __________________________.
    1 family member develops suspected or confirmed influenza and any other family member is at high risk for complications
  8. Antiviral chemoprophylaxis is recommended for ALL residents (vaccinated and unvaccinated) in institutions that are_____________________________________________________________.
    Experiencing influenza outbreaks (≥ 2 residents with influenza-like symptoms within 72 hours)
  9. What Herpesviridae are associated with encephalitis or Meningitis?
    HHV
  10. What Herpesviridae are associated with Mononucleosis?
    EBV
  11. What are the Alphaherpesviruses?
    • HSV-1
    • HSV-2
    • VZV
  12. What are the Betaherpesviruses?
    • HHV-6
    • HHV-7
    • CMV
  13. What are the Gammaherpesviruses?
    • EBV
    • HHV-8
  14. HHV stands for:
    Human herpes virus
  15. CMV stands for:
    Cytomegalovirus
  16. EBV stands for:
    Epstein-Barr virus
  17. HSV stands for:
    Herpes simplex virus
  18. VZV stands for:
    Varicella-zoster virus
  19. What are the common locations for HSV-1 to manifest?
    • Mouth
    • Skin
    • Face
    • Esophagus
    • Brain
  20. What are the common locations for HSV-2 to manifest?
    • Genitals
    • Rectum
    • Skin
    • Hands
    • Meninges
  21. HSV can be treated with what drugs?
    • Acyclovir (Zovarix)
    • Valacyclovir (Valtrex)
    • Famcyclovir (Famvir)
    • Penciclovir (Denavir)
    • Foscarnet (Foscavir)
  22. Which drug has lower bioavailability at higher doses?
    Acyclovir
  23. What is the oral bioavailability of Valacyclovir?
    70%
  24. What is Acyclovir/Valacyclovir’s activity spectrum?
    • Most against HSV-1 and half as active against HSV-2
    • Some activity against CMV, VZV, and EBV
  25. What group would you dose adjust Acyclovir/Valacyclovir in?
    Renal impairment
  26. What group is usually resistant to Acyclovir/Valacyclovir?
    Immunocomprimised
  27. What are the SE for Acyclovir/Valacyclovir?
    • Renal insufficiency (IV form = crystalline nephropathy)
    • Phlebitis/Injection site reactions
    • Neurotoxicity
    • Thrombotic thrombocytopenia purpura ( At very high doses)
    • N/V
  28. How can you reduce the risk of injection site reactions with Acyclovir/Valacyclovir?
    Reduce the dose to < or = to 7 mg/mL (10 mg/mL in fluid restricted patients)
  29. What is the spectrum of activity for Famciclovir and Penciclovir?
    HSV-1, HSV-2 and VZV
  30. What are the SE for Famciclovir and Penciclovir?
    • HA/migraine
    • Diarrhea
    • Utricaria
    • Hyperbilirubunemia
    • Myelosuppression
    • N/V
  31. When should you dose adjust Famciclovir/Penciclovir?
    For renal insufficiency
  32. What is the activity spectrum fro Docosnol?
    • HSV-1
    • HSV-2
    • CMV
    • Influenza
    • HHV-6
    • RSV
    • Not virucidal (stops virus from entering the cell)
  33. What is the expected benefit of Ducosonol?
    Reduces the duration of symptoms attributed to cold sores and fever blisters
  34. How should Ducosonal be administered?
    • 10% cream 5 times a day to lesions
    • Beginning at start of symptoms
    • Up to 10 days
  35. What are the dependent factors for treatment choice of Orolabial HSV in an immunocompetent host?
    • Primary or secondary disease
    • Severity of symptoms
    • Site of infection
    • Frequency of reoccurance
  36. What medications are indicated for primary orolabial HSV in an immunoCOMPETENT host and what are their doses?
    • Acyclovir 400 mg PO TID x7-10 days OR 5 mg/kg IV Q8
    • Famicilovir 500 mg PO TID x7 days
    • Valacyclovir 1g PO BID x7 days
  37. How is Orolabial HSV reactivation disease usually treated?
    No treatment for most immunocompetent hosts w/ minimal symptoms
  38. When should chronic suppressive therapy be used for Orolabial HSV reactivation disease?
    • Frequent bothersome occurances
    • Associated with systemic effects (Erythemia multiforme, Aseptic meningitis)
    • ImmunoCOMPRIMISED host
    • Patients without prodromal symptoms
  39. What drugs are available for Herpes labialis reactivation disease?
    • Acyclovir
    • Famciclovir
    • Valacyclovir
    • Penciclovir cream
  40. What is the dose for Acyclovir in the treatment of Herpes Labialis reactivation disease?
    • Episodic:
    • PO = 400 mg PO 5x/day x5 days
    • Topical 5% cream = 5 times per day x4 days
    • Chronic suppression:
    • 400 mg PO bid
  41. What is the dose for Famciclovir in the treatment of Herpes Labialis reactivation disease?
    • Episodic: 1500 mg PO x 1 dose
    • Chronic suppression: 500 mg PO BID
  42. What is the dose for Valacyclovir in the treatment of Herpes Labialis reactivation disease?
    • Episodic: 2 grams PO BID x 1 day
    • Chronic Suppression: 500-1000 mg PO QD
  43. What is the dose for Penciclovir 1% cream in the treatment of Herpes Labialis reactivation disease?
    Q2H during the day for 4 days
  44. Single-day dosing with either ____________ or _____________affords greater patient convenience and overall lower cost when compared with 5 days of acyclovir
    famciclovir or valacyclovir
  45. Randomized trials of patients with sporadic recurrences of HSV-1 infection showed _____________therapy with creams or ointments are of modest benefit.
    topical antiviral
  46. What age cut off determines whether you should or should not treat for VZV?
    > or = to 13 should usually be treated (Also says >12)
  47. What are the S/S of Varicella?
    • Vesicular rash
    • Low grade fever
    • Malaise
    • Macropapules/Vesicles/Scabs
    • Pain
    • Pruritis

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