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ID EXAM 5 DRUGS
| DRUG | MOA | MOR | ADR | NOTES |
|---|---|---|---|---|
| Acyclovir (zovirax) | competitive inhibitions of viral DNA pol by acyclovir triphosphate converted to phosphate form through thymine kinase stop sythesis of viral DNA disturbs 3'-5' phosphodiester bond | reduction of tymidine kinase | IV is dose limited by nephrotoxicity, crystalluria and neurotoxicity | converted to monophosphate form through thymidine kinase |
| Valacyclovir (valtrex) | same as acyclovir oral prodrug, better absorbtion from ester groups | reduction of tymidine kinase | nausea, vomit | |
| Famiciclovir (prodrug of penciclovir) | Famiciclovir is oral, due to two acetyl ester groups Penciclovir is topical for herpes labialis | |||
| Ganciclovir, valganciclovir | MOA: similar to acyclovir but uses UL97 gene encoded phosphotransferase istead of thymine kinase IN CMV Valganciclovir is the prodrug of genciclovir | Mutations in viral phosphotransferaase | BOXED WARNING: hematologic toxicity, fetal toxicity, impairmetn of fertility, mutagenic and carcinogenic | used for HCMV retinitis and prevention of HCMV after transplant |
| Cidofovir (only nucleotide) | Does not require specific thymidine kinase | BOXED WARNING: nephrotoxicty, neutropenia (prevent with saline) | use against acyclovir resistant HSV and ganciclovir resistant HCMV | |
| Foscarnate | Inhibition of viral DNA pol | electrolyte imbalances, neurotoxicity, phlebitis, N/V | CMV renitis in AIDS pts acyclovir resistant HSV and VZV | |
| Letermovir (prevymis) | inhibits acivity of terminase complex pUL56 non-nucleoside so no cross resistance | CYP3A4 cyclosporine increases BA |