Fomivirsen is used in:
Correct Answer: CMVinAIDS
Description: Ans: b (CMV in AIDS) Ref: Goodman & Gilman 821FomivirsenFomivirsen is a phosphorothioate antisense oligionucleotide complementary to the mRNA sequence for the major immediate--early region of CMV and inhibits CMV replication through sequence- specific and nonspecific mechanisms, including inhibition of vims binding to cells.Fomivirsen is active against CMV strains resistant to ganciclovir, foscamet, and cidofovir.Fomivirsen is given by intravitreal injection for patients intolerant or unresponsive to other therapies for CMV retinitis.Following injection, it is cleared from the vitreous humor with a t|/2of ~55 hours through distribution to the retina and probably local exonuclease digestion. In HIV infected patients with refractory, sight- threatening CMV retinitis, fomivirsen injections significantly delay retinitis progression.Ocular side effects include iritis in up to 25% of patients, which can be managed with topical glucocorticoids, vitritis, cataracts, and increased intraocular pressure in 15-20% of patients. Recent cidofovir use may increase the risk of inflammatory reactions.Notes on antiviral therapyIntravenous acyclovir is the treatment of choice for herpes simplex encephalitis, neonatal HSV infection, and serious HSV or VZV infectionsPalivizumab is a humanized monoclonal antibody directed against an epitope in the A antigen site on the F surface protein of RSV. It is licensed for the prevention of RSV infection in high-risk infants and children such as premature infants and those with bronchopulmonary dysplasia or congenital heart disease.Intravenous foscamet is used for CMV retinitis, including ganciclovir-resistant infections, other types of CMV infection, and acyclovir-resistant HSV and VZV infections. Foscamet's major dose-limiting toxicides are nephrotoxicity and hypocalcemia.The neuraminidase inhibitors zanamivir and oseltamivir, analogs of sialic acid, interfere with release of progeny influenza virus from infected to new host cells, thus halting the spread of infection within the respiratory tract. Unlike amantadine and rimantadine, zanamivir and oseltamivir have activity against both influenza A and influenza B viruses.
Category:
Pharmacology
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