Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Boards Pharm 01: Antimicrobials > 7. Antivirals > Flashcards

7. Antivirals Flashcards

1
Q

Amantadine / Rimantadine - MOA

A

Block viral penetration / uncoating (M2 ion channel protein)
- Also causes Dopamine release from intact nerve terminals.

“A MAN 2 DINE takes off his COAT”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Amantadine / Rimantadine - Clinical Use

A

Prophylaxis and treatment of Influenza A –> Recent CDC report that 100% of all influenza A now resistant –> no longer used.
- PARKINSON’S

“Amantadine blocks influenza A and causes problems with the cerebellA”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Amantadine / Rimantadine - Toxicities

A

Ataxia, dizziness, slurred speech

“Amantadine blocks influenza A and causes problems with the cerebellA”

  • Rimantadine does not cross BBB - Less CNS side effects.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Amantadine / Rimantadine - Resistance

A

Mutated M2 protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Zanamivir / Oseltamivir - MOA

A

Inhibit Influenza neuraminadase –> prevent release of progeny virus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Zanamivir / Oseltamivir - Clinical Use

A

INFLUENZA A and B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Ribavirin - MOA

A

Inhibits synthesis of guanine nucleotides by competitively inhibiting IMP dehydrogenase

Inhibit RNA genome replication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Ribavirin - Clinical Use

A

RSV

- CHRONIC HEPATITIS C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Ribavirin - Toxicities

A

Hemolytic anemia

-Severe teratogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Acyclovir - MOA

A

Monophosphorylated by HSV/VZV thymidine kinase –> Guanisine analog –> preferentially inhibits viral DNA via chain termination (Cellular enzymes make a triphosphate).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Acyclovir - Clinical Use

A

HSV (mucocutaneous, genital, and encephalitis), VZV, EBV

  • Prophylaxis in immunocompromised
  • No effect on latent forms of HSV and VZV
  • Valacyclovir is prodrug of Acyclovir with better bioavailability
  • For Herpes Zoster use Famciclovir
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Acyclovir - Toxicities

A

Few serious side effects, possible nephrotoxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Acyclovir - Resistance

A

Lack of viral thymidine kinase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Ganciclovir - MOA

A

5’-Monophosphate formed by CMV viral kinase –> Guanosine analog –> preferentially inhibits viral DNA via chain termination (Cellular enzymes make a triphosphate).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Ganciclovir - Clinical Use

A

CMV especially in immunocompromised

- Valganciclovir is prodrug of Ganciclovir with better bioavailability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Ganciclovir - Toxicities

A

Leukopenia, Neutropenia, Thrombocytopenia, renal toxicity

- More toxic to host enzymes than Acyclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Ganciclovir - Resistance

A

Mutated CMV DNA polymerase or lack of viral kinase

18
Q

Foscarnet - MOA

A

Viral DNA polymerase inhibitor that binds to the pyrophosphate binding site of the enzyme.
- does not require activation by viral kinase.

“FOScarnet is a pyroFOSphate analog”

19
Q

Foscarnet - Clinical Use

A

CMV RETINITIS in immunocompromised when Ganciclovir fails.

20
Q

Foscarnet - Toxicities

A

Nephrotoxicity

21
Q

Foscarnet - Resistance

A

Mutated DNA polymerase

22
Q

Cidofovir - MOA

A

Preferentially inhibits viral DNA polymerase

- Does not require phosphorylation by viral kinase

23
Q

Cidofovir - Clinical Use

A

CMV retinitis in immunocompromised patients

  • Acyclovir resistant HSV
  • Long half life
24
Q

Cidofovir - Toxicities

A

Nephrotoxicity

- Coadminister with Probenacid

25
Q

HIV Therapy

A

HAART

  • Initiated when patient presents with AIDs defining illness, low CD4 (<500), or a high viral load.
  • 3 drug regimen
    • 2 NRTIs + 1 NNRTI
    • 2 NRTIs + 1 protease inhibitor
    • 2 NRTIs + 1 integrase inhibitor
26
Q

Protease Inhibitors - Available Drugs

A 
Lopinavir
Atazanavir
Darunavir
Fosamprenavir
Saquinavir
Ritonavir

” -navir “

27
Q

Protease Inhibitors (“-navir”) - MOA

A

Inhibit HIV protease –> Prevent cleavage of HIV protein products into their functional parts –> Prevent maturation of new virus.
- Ritonavir can boost other drug concentrations by inhibiting P450

“NAVIR (never) TEASE a proTEASE”

28
Q

Protease Inhibitors (“-navir”) - Toxicities

A

Hyperglycemia, GI intolerance, lipodystrophy

29
Q

NRTIs - Available Drugs

A 
Tenofovir (TDF)
Emtricitabine (FTC)
Abacavir (ABC)
Lamuvudine (3TC)
Zudovudine (ZDV, formerly AZT)
Didanosine (ddI)
Stavudine (d4T)
30
Q

NRTIs (Tenofovir, Zidovudine, etc..) - MOA

A

Competitively inhibit addition of nucleotides

  • Lack a 3’ OH
  • Chain terminators
  • All except Tenofovir (a nucleotide) must be phosphorylated by thymidine kinase to be active

ZDV is used for general prophylaxis and during pregnancy to reduce risk of fetal transmission.

“Have you DINEd (-vuDINE) with my NUCLEar (NUCLEosides) family?”

31
Q

NRTIs (Tenofovir, Zidovudine, etc..) - Toxicities

A

Bone marrow suppression (Can be reversed with G-CSF and EPO)

  • Peripheral neuropathy, lactic acidosis
  • ZDV can cause megaloblastic anemia.
32
Q

NNRTIs - Available Drugs

A

Nevirapine
Efavirenz
Delaviridine

” -vir- “

33
Q

NNRTIs (Nevirapine, Efavirenz, Delaviridine) - MOA

A

Bind reverse transcriptase at site different from NRTIs.

- Do not require phosphorylation to be active

34
Q

NNRTIs (Nevirapine, Efavirenz, Delaviridine) - Toxicities

A

Bone marrow suppression (Can be reversed with G-CSF and EPO)

- Peripheral neuropathy, rash

35
Q

Integrase Inhibitors - Available Drugs

A

Raltegravir

36
Q

Integrase Inhibitors (Raltegravir) - MOA

A

Inhibit HIV genome integration into host cell chromosome by reversibly inhibiting HIV integrase.

37
Q

Integrase Inhibitors (Raltegravir) - Toxicities

A

Hypercholesterolemia

38
Q

Interferons - Available Drugs

A

IFN-a
IFN-b
IFN-g

39
Q

Interferons - MOA

A

Glycoproteins normally synthesized by virus infected cells that block replication of both DNA and RNA viruses.

40
Q

Interferons - Clinical Use

A

IFN-a - Chronic Hep. B and C, Kaposi’s sarcoma
IFN-b - MS
IFN-g - NADPH oxidase deficiency

41
Q

Interferons - Toxicities

A

Neutropenia

Boards Pharm 01: Antimicrobials (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions