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M3 Pharm B3 > Anti-infective Drugs 1b - Antivirals > Flashcards

Anti-infective Drugs 1b - Antivirals Flashcards

1
Q

Common Non-HIV Viral Infections (6)

A
  1. Herpes Simplex (oral-facial, genital, encephalitis)
  2. Varicella-Zoster
    Chickenpox (varicella)
    Shingles (herpes zoster)
  3. Cytomegalovirus
  4. Hep B, C, and D
  5. Respiratory Synctial Virus (RSV)
  6. Influenza A & B
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2
Q

Non-HIV Antiviral Classification: Herpes Simplex and Herpes Zoster Antivirals (4)

A

Nucleoside analogs

  1. Acyclovir
  2. Valacyclovir
  3. Famciclovir
  4. Penciclovir
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3
Q

Non-HIV Antiviral Classification: CMV Antivirals (2)

A

Nucleoside analogs that require activation by viral kinase

  1. Ganciclovir
  2. Valganciclovir
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4
Q

Non-HIV Antiviral Classification: Others for CMV Antivirals (2)

A
  1. Foscarnet
  2. Cidofovir

When CMV is ganciclovir resistant

Activation not required

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5
Q

Non-HIV Antiviral Classification: Hepatitis B and C Antivirals (3)

A
  1. Nucleotide/nucleoside analogs
  2. Interferon alfa
  3. Ribavirin
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6
Q

Non-HIV Antiviral Classification: Neuramididase inhibitors for influenza (2)

A
  1. Oseltamivir (Tamiflu)

2. Zanamivir (Relenza)

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7
Q

Non-HIV Antiviral Classification: Adamatanes for influenza (2)

A
  1. Amantadine

2. Rimantadine

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8
Q

Antiretroviral Drug Classification for HIV Infection (5)

A
  1. Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTI)
  2. Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTI)
  3. Protease Inhibitors (PI)
  4. Entry and Fusion and Inhibitors
  5. Integrase Inhibitor
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9
Q

Antiretroviral Drug Therapy Issues (5)

A
  1. Multiple drug therapy combinations
  2. Significant adverse reactions
  3. Multiple drug-drug interactions
    • between antiretroviral drugs
    • with many other drugs used by HIV patient s
  4. High cost
  5. Adherence
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10
Q

Antiviral Drugs MOA 1 and Drugs (3)

A
  1. Inhibition of viral penetration and uncoating
  2. Amantadine
  3. Rimantadine
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11
Q

Antiviral Drugs MOA 2 and Drugs (4)

A
  1. Inhibition of Viral DNA Polymerase
  2. Acyclovir
  3. Gancyclovir
  4. Famcyclovir
  5. Valacyclovir
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12
Q

Antiviral Drugs MOA 3 and Drugs (1)

A
  1. Inhibition of Viral DNA and RNA Polymerase

Foscarnet

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13
Q

Antiviral Drugs MOA 4 and Drugs (1)

A
  1. Inhibition of viral RNA polymerase

Ribavirn

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14
Q

Antiviral Drugs MOA 5 and Drugs (6)

A
  1. Inhibition of Viral Reverse Transcriptase
  2. Zidovudine
  3. Didanosine
  4. Zalcitabine
  5. Stavudine
  6. Lamivudine
  7. Nevirapine
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15
Q

Antiviral Drugs MOA 6 and Drugs (4)

A
  1. Inhibition of Viral Aspartate Protease
  2. Indinavir
  3. Ritonavir
  4. Saquinavir
  5. Nelfinavir
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16
Q

Antiviral Drugs MOA 7 and Drugs (2)

A
  1. Inhibition of Viral Neuraminidase
  2. Zanamivir
  3. Oseltamivir
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17
Q

Clinical Antiviral Drugs: Amantadine - MOA

A

Interfere with the attachment, penetration, and uncoating of the viral particle

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18
Q

Clinical Antiviral Drugs: Amantadine - Indications (2)

A
  1. Influenza A

2. Parkinson’s Disease

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19
Q

Clinical Antiviral Drugs: Amantadine - Side Effects (2)

A
  1. Livedo reticularis

1. Anticholinergic effects

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20
Q

Clinical Antiviral Drugs: Ribavirin - MOA (2)

A
  1. Inhibits viral RNA polymerase

2. Inhibits end capping of viral mRNA

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21
Q

Clinical Antiviral Drugs: Ribavirin- Indications (1)

A

RSV

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22
Q

Clinical Antiviral Drugs: Ribavirin - Side Effects (1)

A

Teratogenic

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23
Q

Clinical Antiviral Drugs: Acyclovir - MOA

A

Inhibits viral DNA polymerase

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24
Q

Clinical Antiviral Drugs: Acyclovir - Resistance

A

Decrease activity to viral thymidylate kinase

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25
Q

Clinical Antiviral Drugs: Acyclovir - Indications (3)

A
  1. Herpes Simplex
  2. Varicella zoster (shingles)
  3. Not effective in CMV infections
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26
Q

Clinical Antiviral Drugs: Acyclovir - Side Effects (2)

A
  1. Nephropathy (IV only)

2. Neurotoxicity and Crystalluria

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27
Q

Clinical Antiviral Drugs: Famiciclovir and Valacyclovir

A

Newly FDA approved for herpes simplex

Similar to acyclovir

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28
Q

Clinical Antiviral Drugs: Ganciclovir - Buzzword

A

Rx of CMV (phosphotransferase)

Viral thymidylate kinase in herpes

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29
Q

Clinical Antiviral Drugs: Ganciclovir - MOA

A

Similar to acyclovir:

Inhibits viral DNA polymerase

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30
Q

Clinical Antiviral Drugs: Ganciclovir - Side Effects (3)

A
  1. Leukopenia, thrombocytopenia
  2. Seizure in overdose
  3. Crystalluria
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31
Q

Clinical Antiviral Drugs: Foscarnet - MOA

A

Inhibits DNA polymerase

32
Q

Clinical Antiviral Drugs: Foscarnet - Indications (3)

A

As Ganciclovir

Rx of CMV retinitis in AIDS patients, not retinal detachment

33
Q

Clinical Antiviral Drugs: Foscarnet - Side Effects (1)

A
  1. Nephrotoxicity
34
Q

Clinical Antiviral Drugs: Foscarnet - Drug Interactions and Result

A

IV pentamidine + Foscarnet —> severe hypocalcemia

35
Q

Clinical Antiviral Drugs: Zanamivir and Oseltamivir - MOA

A

Inhibits neuraminidases of influenza A and B

36
Q

Clinical Antiviral Drugs: Zanamivir and Oseltamivir - Indications

A

Prophylaxis to reduce flu symptoms

37
Q

Clinical Antiviral Drugs: Zanamivir and Oseltamivir - Side Effects (2)

A
  1. Inhaled Zanamivir –> throat irrituation

2. Nausea and vomiting

38
Q

5 Classes Drugs Used for AIDS: 1. Nucleoside Reverse Transcriptase Inhibitors - MOA

A

Phosphorylated to triphosphate that inhibit RT

39
Q

5 Classes Drugs Used for AIDS: 1. Nucleoside Reverse Transcriptase Inhibitors - Resistance

A

Specific point mutations in the RT gene

40
Q

5 Classes Drugs Used for AIDS: 1. Nucleoside Reverse Transcriptase Inhibitors - Zidovudine (AZT) Adverse Effects (3)

A
  1. Bone marrow suppression: Neutropenia
  2. Peripheral neuropathy
  3. Lactic acidosis (rare)
41
Q

5 Classes Drugs Used for AIDS: 1. Nucleoside Reverse Transcriptase Inhibitors - Didanosine (DDI) Adverse Effects (2)

A
  1. Pancreatitis

2. Hyperurecemia

42
Q

5 Classes Drugs Used for AIDS: 1. Nucleoside Reverse Transcriptase Inhibitors: Zalcitabine (DDC) Adverse Effects (1)

A

Peripheral neuropathy

43
Q

5 Classes Drugs Used for AIDS: 1. Nucleoside Reverse Transcriptase Inhibitors: Stavudine (D4T) Adverse Effects (1)

A

Peripheral neuropathy

44
Q

5 Classes Drugs Used for AIDS: 1. Nucleoside Reverse Transcriptase Inhibitors: Lamivudine (3TC) Adverse Effect (1) and Buzzword

A

GI Distress

Buzzword: First oral drug for Hepatitis B that removes sAg from blood

45
Q

5 Classes Drugs Used for AIDS: 1. Nucleoside Reverse Transcriptase Inhibitors: Latest Update of Adefovir

A

FDA approved for HBV

NOT APPROVED FOR HIV DUE TO RENAL TOXICITY

46
Q

5 Classes Drugs Used for AIDS: 1. Nucleoside Reverse Transcriptase Inhibitors: Emtricitabine

A

New NRTI is a fluorothiacytidine

Usually combined with zidovudine or Tenofovir

47
Q

5 Classes Drugs Used for AIDS: 1. Nucleoside Reverse Transcriptase Inhibitors: Tenofovir Side Effects (2)

A
  1. Headache

2. GI Intolerance

48
Q

Zidovudine is often combined with?

A

Lamivudine or emtricitabine

49
Q

Zidovudine is NOT used with?

A

Stavudine because it’ll have antagonistic effects

50
Q

5 Classes Drugs Used for AIDS: 2. Non-Nucleotide Reverse Transcriptase Inhibitors - Drugs (3)

A
  1. Delaviridine
  2. Nevirapine
  3. Efavirenz
51
Q

5 Classes Drugs Used for AIDS: 2. Non-Nucleotide Reverse Transcriptase Inhibitors - Side Effects (2)

A
  1. Rash

2. No bone marrow suppression as NRTI

52
Q

5 Classes Drugs Used for AIDS: 3. Protease Inhibitors - MOA

A

Inhibit Aspartate protease by binding the dipeptide

53
Q

5 Classes Drugs Used for AIDS: 3. Protease Inhibitors - Resistance

A

Point mutation in the pol encoded gene

54
Q

5 Classes Drugs Used for AIDS: 3. Protease Inhibitors - Indinavir Adverse effects (3)

A
  1. Nephrolithiasis
  2. Hyperbilirubinemia
  3. Inhibition of p450
55
Q

5 Classes Drugs Used for AIDS: 3. Protease Inhibitors - Ritonavir Adverse Effects (3)

A
  1. GI Distress
  2. Inhibit p450
  3. Increase effects of dronabinol and rifampin
56
Q

5 Classes Drugs Used for AIDS: 3. Protease Inhibitors - Ritonavir Buzzword (2)

A

Inhibits the metabolism of other protease inhibitors

Boosted therapy

57
Q

5 Classes Drugs Used for AIDS: 3. Protease Inhibitors - Nelfinavir Adverse effects (1)

A

GI Distress

58
Q

5 Classes Drugs Used for AIDS: 3. Protease Inhibitors - Saquinavir Adverse Effect (1)

A

GI Distress

59
Q

5 Classes Drugs Used for AIDS: 3. Protease Inhibitors - Atazanavir Adverse Effect (1)

A

Proloned PR Interval

60
Q

5 Classes Drugs Used for AIDS: 3. Protease Inhibitors - Lopinavir Adverse Effect (1)

A

GI intolerance

61
Q

Protease inhibitors are reported to produce (2)?

A
  1. Abnormal lipid and CHO metabolism

2. Central adiposity and insulin resistance

62
Q

5 Classes Drugs Used for AIDS: 4. Fusion ad Entry Inhibitors - Enfuvirtide MOA

A

Bind to HIV glycoprotein 41 and blocks the fusion process

63
Q

5 Classes Drugs Used for AIDS: 4. Fusion ad Entry Inhibitors - Enfuvirtide Adverse Effects (1)

A

Hypersensitivity reactions

64
Q

5 Classes Drugs Used for AIDS: 4. Fusion ad Entry Inhibitors - Maraviric MOA

A

CCR5 Antagonist (Chemokine co-receptors 5)

65
Q

5 Classes Drugs Used for AIDS: 4. Fusion ad Entry Inhibitors - Maraviric Adverse Effects (2)

A
  1. Upper respiratory symptoms

2. Possible hepatotoxicity

66
Q

5 Classes Drugs Used for AIDS: 5. Integrase Inhibitors - Raltegravir MOA

A

Prevents DNA strand transfer

67
Q

5 Classes Drugs Used for AIDS: 5. Integrase Inhibitors - Raltegravir *Use

A

*Used for HIV-1 infection RESISTANT TO MULTIPLE ANTIRETROVIRLS

68
Q

5 Classes Drugs Used for AIDS: 5. Integrase Inhibitors - Raltegravir - Adverse Effects (4)

A

1-3: NVD

  1. Headache
69
Q

HIV Drugs are used in?

A

Combinations –> drug cocktails

HAART: Highly Active Antiretroviral Therapy

70
Q

AIDS: Buzzword

71
Q

AIDS: When do you start therapy?

A

Antiretroviral treatment in all patients with HIV Infection regardless of CD4 counts

New 2014 guidelines

72
Q

AIDS: Recommended Treatment

A

2 NRTIs + 1 NNRTI or a Protease Inhibitor

73
Q

AIDS: Recommended Treatment Examples

A

Any 2 Nucleoside Inhibitors: AZT, DDI, 3TC, D4T

+

1 Protease Inhibitor: Indinavir or Ritonavir

74
Q

Drugs with “a” in vir?

75
Q

Drugs with “i” in vir?

76
Q

Drugs with “o” in vir?

M3 Pharm B3 (10 decks)

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