2. prototypes

HSV-1 - disease, ss, transmission, treatment, prevention

disease: Oral herpes, occasionally genital
ss: Blisters, tingling, discomfort

trans: Direct contact

tx: Antivirals

prevention: Safe sex

HSV-2 - disease, ss, transmission, treatment, prevention

Disease: Genital herpes, occasionally oral
ss: Painful sores, itching, discomfort

trans: Direct contact

tx: Antivirals

prevention: Safe sex

VZV - disease, ss, transmission, treatment, prevention

disease: Chickenpox (primary), Shingles (reactivation)
ss: Vesicular rash, fever, fatigue

transmission: Airborne / contact

tx: Antivirals

prevention: vaccine

CMV - disease, ss, transmission, treatment, prevention

disease: Cytomegalovirus infection
ss: Often asymptomatic; fever, malaise, lymphadenopathy in symptomatic cases
transmission: Body fluids

Tx: Antivirals, monitoring
prevention: Hygiene

EBV - disease, ss, transmission, treatment, prevention

disease: Infectious mononucleosis
ss: Fever, fatigue, sore throat, lymphadenopathy
transmission: Saliva / close contact

tx: Supportive

prevention: Limit exposure

HSV-6 - disease, ss, transmission, treatment, prevention

disease: Roseola (infants)

ss: High fever → pink rash

transmission: Respiratory droplets

Tx: supportive

prevention: Hygiene

acyclovir (zovirax) 2 classes, MOA, thera effects

2 classes: antiviral for herpesviruses, nucleoside analog

MOA: inhibits viral replications; activated by viral enzymes - terminates viral DNA synthesis

thera effects: treat HSV-1, HSV-2 (most effective), VZV (chikpox), CMV(immunocomp), prevents HSV recurrence

acyclovir (zovirax) contraindications, ADR, drug interactions, preg

contrain: caution in chronic kidney disease

ADR: NV, LFT elevation, skin irritation, thrombocytopenia, hemolytic uremic syndrome, nephrotoxicity, neurotoxic, pruritus

Drug interactions: may interact with nephrotoxic drugs (NSAIDs)

Preg: b

oseltamivir (tamiflu) 2 classes, thera effects, MOA

2 classes: antiviral - influenza, viral replication inhibitor

thera effects: treatment and prevention of influenza A & B

MOA: inhibits influenza neuraminidase - prevents viral replication and release of new virions

oseltamivir (tamiflu) contrain, ADR, BB, interactions, Preg

contrain: Hypersensitivity, severe renal impairment, history of seizures, psychoses, cardiac disease

ADR: Nausea, vomiting, delirium, behavioral changes, headache

BB: are neuropsychiatric events (delirium, self-injury), anaphylaxis, Stevens-Johnson Syndrome, renal toxicity in CKD

interactions: Live attenuated influenza vaccine (LAIV), nephrotoxic drugs

preg: c

Hepatitis virus - HAV

envelope: ssRNA/none

stablity: stable in environment

course: acute

transmission: fecal-oral

key outcome: self-limiting

Hepatitis virus - HBV

envelope: DNA/ enveloped

stability: fragile outside

course: acute/ chronic

transmission: blood, sexual, perinatal

key outcome: can hide in liver; cirrhosis/liver cancer

Hepatitis virus - HCV

envelope: ssRNA / enveloped

stability: fragile outside

course: often chronic

transmission: bloodborne

key outcome: rapid mutation; cirrhosis = liver cancer risk

Hepatitis virus - HDV

envelope: ssRNA/ enveloped

stablity: fragile outside

course: requires HBV

transmission: bloodborne

key outcome: worsens, HBV outcomes

Hepatitis virus - HEV

genome/ envelope: ssRNA / none

stability: stable in environment

course: acute

transmission: fecal-oral

key outcome: severe in pregnancy

tenofovir (viread) - 2 classes, thera effects, MOA

2 classes: antiviral HBV, HIV - NRTI

thera effects: HIV-1 infections, chronic HBV infections, HIV PrEP

MOA: inhibits HIV reverse transcriptase and HBV polymerase - prevents viral DNA synthesis

tenofovir (viread) - contrain, ADR, BB, interactions, preg

contrain: hypersensitivity, severe renal impairment, lactations

ADR: ND, h/a, fatigue

BB: lactic acidosis, severe hepatomegaly with steatosis, renal toxicity (fanconi syndrome)

interactions: drugs affecting renal function or eliminated renally (NSAIDs, nephro meds)

Preg: b

zidovudine (AZT) 2 classes, thera effects, MOA

2 classes: antireoviral for HIV/AIDS

Thera effects: EBV, hepatitis B virus, and HIV infections

MOA: inhibits synthesis of DNA by reverse transcriptase

zidovudine (AZT) Contrain, ADR: BB, interactions, Preg

Contrain: hypersensitivity, breast-feeding, lactic acidosis

ADR: GI symptoms, Headache, seizures, somnolence

Black Box: hematologic toxicities, fatal lactic acidosis

interactions: Ganciclovir, acetaminophen, interferon beta-1b, probenecid, rifampin,
trimethoprim, and valproic acid

Preg: C

Efavirenz (sustiva) - 2 classes, therapeutic effects, MOA

classes: antiretroviral, nonucleoside reverse transcriptase inhibitor

therapeutic effects: HIV-! infection with other ARTs

MOA: inhibits HIV reverse transcriptase

Efavirenz (sustiva) - contraindications, ADR, interactions, pregnancy

contrain: hypersensitivity, hepatitis

ADR: dizziness, impaired concentration, insomnia, abnormal dreams, and hallucinations

Interactions: drugs metabolized by p-450 CYP3A4

pregnancy: D

raltegravir (isenttress) 2 classes, therapeutic effects, MOA

classes: antiretroviral, integrase inhibitor

effects: PEP, ART resistance, consider first-line antiretrovirals for treatment naive-patients

MOA: inhibits HIV integrase to prevent viral insertion into host DNA. Start within 24-36 hrs of exposure

raltegravir (isenttress) Contraindications, ADR, interactions, preg,

contrain: Hypersensitivity, myopathy or rhabdomyolysis risk, psychiatric
disorder, Phenylketonuria (PKU)

ADR: ND, Abd pain, flatulence, HA, fatigue

inter: lipid lowering agents, PPIs, Rifampin

Preg: C

ritonavir (norvir) 2 classes, therapeutic effects, MOA

classes: antiretroviral, protease inhibitor

thera effects: treats HIV infections in adult

MOA: Competitive inhibitor of HIV protease → viral proteins remain uncleaved
→ produces immature, non-infectious virions → limits viral spread

ritonavir (norvir) contrain, ADR, interactions, preg category

Contrain: Severe liver impairment, active viral hepatitis, uncontrolled diabetes

ADR: Abdominal pain, NVD, stomach discomfort, insomnia, headache, hyperglycemia

inter: drugs metabolized by CYP450 (e.g., statins, some sedatives)

preg: c