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Antivirals - Coggle Diagram
Antivirals
Oseltamivir
Activity:
Influenza seasonal tx+ppx & Influenza A tx+ppx
Side Effects:
N/V, Confusion, delerium, hallucinations
Seasonal Influenza
Tx:
75 mg BID PPx: 75 mg qd x7 days (vaxed) x14 days (unvaxed)
Influenza A
Tx/PPx: 75 mg bid x5 days
Symptomatic?
--> must be initiated < 48 hrs since onset
Complicated/Hospitalized/Immunocompromized?-->
initite ASAP regarless if > 48 hrs since onset
Acyclovir/ Valacyclovir (prodrug)
5 mg/kg acyclovir= 1000 mg PO Valacyclovir
IV acyclovir is dosed on IBW-
ALWAYS
Activity:
HSV-1, HSV-2, VZV (chickenpox), Herpes Zoster (shingles)
Side Effects:
TTp/HUS, inc Scr/BUN, Inc LFTs, neutropenia, seizures
Monitoring:
renal fctn, LFTs, CBC
Ganciclovir/Valganciclovir (prodrug)
Activity:
CMV 1st line, ppx for transplant patients (donor +/recipient -)
Side Effects:
Fever, N/V/D, thrombocytopenia, anorexia, Inc Scr, seizures, retinal detachment, leukopenia
Monitoring:
PLTs, Scr, CBC, retinal exam
~BBW for myelosuppression~
IV ganciclovir 5 mg/kg= PO valganciclovir 900 mg
Gan Tx
: 5 mg/kg IV BID
Val Tx:
900 mg PO BID
Remdesivir
Day 1: 200 mg IV Day 2: 100 mg qd x5 days
Population: Up to invasive mechanical ventilation or ECMO
Side Effects:
Bradycardia, reversible transaminase elevations, hypersensitivity/infusion rnxa
Monitoring:
LFTs (stop if > 10x ULN)
foscarnet
Activity:
refractory CMV, (val)ganciclovir resistant strains
Side Effects:
hypokalemia, hypocalcemia, hypomagnesia, hypophosphatemia, inc Scr/BUN, QT prolongation
Monitoring:
electrolytes, CMP, renal fctn
~BBW for renal impairment, seizures~
Induction:
90 mg/kg IV q12h or 60 mg/kg q8h x2-3wks
Maintenance:
90-120 mg/kg IV qd