196.2 📚 國考版

196.2.0.1 必背 — Acyclovir + Family

  • TK-dependent → HSV/VZV only
  • Renal toxicity (crystal nephropathy) — hydration
  • Foscarnet for acyclovir-R (no TK needed)

196.2.0.2 必背 — Ganciclovir + Valganciclovir

  • CMV (UL97 phosphotransferase)
  • Bone marrow suppression primary toxicity
  • G-CSF if neutropenia

196.2.0.3 必背 — Foscarnet

  • Direct polymerase inhibitor (no TK)
  • Severe electrolyte/renal toxicity
  • For resistant herpesvirus

196.2.0.4 必背 — Letermovir (CMV terminase)

  • No marrow toxicity
  • CMV prophylaxis post-HSCT
  • 2017 FDA

196.2.0.5 必背 — Maribavir (CMV UL97 kinase)

  • Refractory/resistant CMV transplant
  • Dysgeusia (taste change) common
  • 2021 FDA

196.2.0.6 必背 — Influenza

  • Oseltamivir 75 bid × 5d (< 48 hr onset)
  • Baloxavir single dose
  • Pregnancy: oseltamivir safe + recommended

196.2.0.7 必背 — RSV

  • Nirsevimab (single dose mAb) — universal infants 2024 ACIP
  • Maternal RSVpreF alt at 32-36 wk
  • Palivizumab older

196.2.0.8 必背 — COVID

  • Paxlovid (nirmatrelvir-ritonavir) — main outpatient
  • Drug interactions䞥重 with ritonavir
  • Remdesivir — IV
  • Molnupiravir less effective

196.2.0.9 必背 — Mpox

  • Tecovirimat efficacy 2024 STOMP trial NEGATIVE
  • May still use compassionate