Influenza Drugs

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Questions and Answers

Why are amantadine and rimantadine no longer recommended for treating influenza?

  • They are primarily effective against influenza B, which is now less common.
  • Resistance to these drugs has become widespread among influenza A strains. (correct)
  • They have been replaced by newer drugs with fewer side effects.
  • Their efficacy is limited to reducing fever, not viral replication.

A patient with a history of asthma is diagnosed with influenza. Which antiviral medication should be avoided?

  • Oseltamivir
  • Zanamivir (correct)
  • Peramivir
  • Baloxavir marboxil

What is the primary mechanism of action of oseltamivir and zanamivir against influenza viruses?

  • Blocking viral entry into host cells by inhibiting hemagglutinin.
  • Preventing the release of new virions from infected cells by inhibiting neuraminidase. (correct)
  • Disrupting the viral protein coat, leading to viral inactivation.
  • Inhibiting viral DNA replication by targeting viral polymerase.

A clinician is deciding whether to prescribe oseltamivir to a patient presenting with flu-like symptoms 72 hours after symptom onset. What factor should most influence the clinician's decision?

<p>The severity of the patient's symptoms; severe symptoms may warrant treatment regardless of the timeline. (C)</p> Signup and view all the answers

Why is aspirin contraindicated for children with influenza?

<p>It increases the risk of Reye’s syndrome, a rare but serious condition. (D)</p> Signup and view all the answers

How does the influenza vaccine protect against influenza?

<p>By stimulating the production of antibodies that recognize and neutralize influenza viruses. (D)</p> Signup and view all the answers

A 70-year-old patient asks about the best type of flu vaccine for them. Which type of vaccine is specifically recommended for individuals in this age group?

<p>High-dose inactivated influenza vaccine. (D)</p> Signup and view all the answers

What is the typical duration of oseltamivir treatment for influenza?

<p>5 days (A)</p> Signup and view all the answers

What differentiates supportive care from antiviral treatment in managing influenza?

<p>Supportive care focuses on symptom relief, while antiviral treatment targets viral replication. (C)</p> Signup and view all the answers

Which of the following is NOT considered a side effect of Zanamivir?

<p>Bradycardia (A)</p> Signup and view all the answers

Flashcards

Oseltamivir (Tamiflu)

Inhibits neuraminidase, preventing viral release. Active against influenza A and B.

Zanamivir (Relenza)

Neuraminidase inhibitor, administered via inhalation. Effective against influenza A and B.

Amantadine & Rimantadine

Block M2 protein, preventing viral uncoating inside the cell and replication. Only for influenza A, resistance greatly limits use.

Neuraminidase

Enzyme that cleaves sialic acid residues from glycoproteins and glycolipids, enabling viral release from infected cells.

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Neuraminidase Inhibitors

Antiviral medication that targets influenza viruses, shortening the duration of illness when taken soon after symptom onset.

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Influenza Vaccination

Annual vaccination against influenza A and B, especially recommended for high-risk groups.

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Supportive Care (Influenza)

Treatment focused on alleviating symptoms and preventing complications, alongside antiviral medications when appropriate.

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Aspirin Contraindication (Children)

Avoid aspirin use in children and adolescents with influenza due to the risk of Reye’s syndrome, a severe and potentially fatal condition.

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Study Notes

  • Baloxavir marboxil, Peramivir, Oseltamivir (Tamiflu), and Zanamivir (Relenza) are drugs for human influenzas.
  • Amantadine & Rimantadine were previously used for influenza A, but are no longer recommended.

Oseltamivir (Tamiflu)

  • Most commonly used influenza drug.
  • For prophylaxis: Take once daily for 10 days.
  • For treatment: Take twice daily (every 12 hours) for 5 days.
  • Must be taken within 48 hours for effectiveness.
  • Decreases flu duration by about one day.
  • Used for influenza B.

Zanamivir (Relenza)

  • Inhalation-based treatment.
  • Used for influenza B.
  • Contraindicated for patients with asthma or COPD.
  • Side effects: Psychiatric events (e.g., confusion, delirium, hallucinations, and self-injury) and bronchospasm.

Spectrum of Activity

  • Includes influenza A, B, and H1N1.

Neuraminidase Inhibitors

  • Oseltamivir and Zanamivir are neuraminidase inhibitors.
  • Neuraminidase is an enzyme that cleaves sialic acid residues from glycoproteins and glycolipids.

Vaccination

  • Covers influenza A and B strains.
  • High-dose killed vaccine is available for people 65 years and above.
  • Live attenuated vaccine is no longer recommended.

Pharmacological Management

  • Supportive care guided by severity of infection.
  • Oseltamivir or zanamivir (neuraminidase inhibitors) should be administered within 48 hours of symptom onset.
  • Rimantadine and amantadine (M2 blockers) are no longer recommended.
  • Aspirin is contraindicated for children due to the increased risk of Reye’s syndrome.

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