Medications for Exam 6

baloxavir marboxil

zanamivir

oseltamivir

Remdesivir

Nirmatrelvir / Ritonavir

Longer intracellular half-life but lower affinity for HSV DNA polymerase than acyclovir

L-valyl ester of acyclovir; enhanced bioavailability (70%)

Used only for episodic treatment of secondary herpes labialis

Oral prodrug of penciclovir

Oral bioavailability (10-30%) decreases with increasing doses

only effective against replicating virus

long intracellular half-life allows for weekly dosing

Not beneficial in outpatients or hospitalized patients who do not require supplemental oxygen

Intravenous vehicle hydroxypropyl betadex may accumulate in renal failure

Contains sulfobutyl ether beta-cyclodextrin sodium (SBECD) which accumulates in renal dysfunction; clinical significance unclear

Drug-drug interactions are a major concern and concomitant medications should be evaluated for interactions before prescribing

Most used antiviral medication for prevention and treatment of influenza

Preferred over XX for those with acute VTE, severe renal dysfunction, or unable to receive pharmacologic VTE prophylaxis

pharmacologic VTE prophylaxis should be given concomitantly

Should not be used in pregnant patients due to concerns for mutagenesis

Should not be prescribed after hospital discharge

Do not use in immunocompromised hosts, in patients hospitalized with influenza infection, pregnancy, or patients ≤ 5 years

contraindicated in patients on mechanical ventilation

Only available as a topic dosage form

If a patient requires hospitalization after starting treatment, the full 5-day treatment course of ritonavir-boosted nirmatrelvir should be completed unless there are drug-drug interactions that preclude its use.