Anti-viral Flashcards
What sorts of viruses can be treated with anti-virals
○ A select few U.R.I. viruses including influenza types A and B and respiratory syncytial virus (R.S.V.). ○ Herpesviruses ○ Cytomegalovirus ○ Human immunodeficiency virus ○ Viral hepatitis B and C
What can be used for the treatment and/or prophylaxis of H1N1
Tamiflu (Oseltamivir) or Relenza (Zanamivir)
What class is Oseltamivir (Tamiflu)
anti-viral
When should oseltamivir be administered
within 48hrs of the onset of symptoms
What is the MOA of oseltamivir (Tamiflu)
Neuramidase inhibition. Tamiflu was the first orally active neuraminidase inhibitor to be commercially developed
What are side effect concerns with oseltamivir
potential adverse neurologic effects including delirium, hallucinations, depression and increased suicidal ideation but the data are not definitive.
What are common side effects of oseltamivir
abdominal pain, N/V, HA
What is the MOA of Zanamivir (Relenza)
blocking the function of the viral neuraminidase protein, thus preventing the virus from budding off from the host cell
What are the indications for zanamivir (relenza)
influenza A and influenza B and avian flu, when given within 48 hours of infection
How is zanamivir (Relenza) administered
inhalation
How is tamiflu administered
PO
What are common side effects of zanamivir
N/V
What is amandatine (symmetrel) used for
Influenza A, early Parkinson’s disease
What is hutchinson’s sign
herpes outbreak on the tip of the nose
What is the MOA of acyclovir (zovirax)
guanosine analog that is incorporated into the viral DNA and inhibits further viral synthesis
How is acyclovir administered
PO, IV, and topical but the topical is worthless
what are common side effects of acyclovir
Headache, nausea and vomiting can occur with oral dose. Transient renal insufficiency can occur with higher IV doses and skin irritation can occur with topical doses
Does acyclovir cross the BBB
Why yes, yes it does.
What drug types are used for HIV
- reverse transcriptase
- Protease inhibitor
- Fusion inhibitor
- integrase inhibitor
What is the current standard treatment for HIV
HAART (highly active antiretroviral therapy )
What drugs normally make up HAART
two nucleoside reverse transcriptase inhibitors plus either a non-nucleoside reverse transcriptase inhibitor (NNRTI) or a protease inhibitor (PI)
What are the three main forms of reverse transcriptase inhibitors
Nucleoside reverse transcriptase inhibitors
Nucleotide reverse transcriptase inhibitors
Non-nucleoside reverse transcriptase inhibitors
What class is Zidovudine (AZT) (retrovir)
Anti-viral, nucleoside reverse transcriptase inhibitor
What is the MOA of zidovudine
pyrimidine analog that is incorporated into the viral DNA by reverse transcriptase, which terminates further replication
what are common side effects of zidovudine
Headaches are common. Potentially toxic to bone marrow with severe anemia and leukopenia in patients receiving high doses
what is the MOA of protease inhibitors
Block the action of protease, the enzyme that cleaves viral protein chains
What class is Saquinavir (Invirase )
anti-viral, protease inhibitor
What are the indications of Saquinavir (Invirase )
HIV, Hep C
What is treated by Interferon alpha
Hep C
What is treated by interferon beta
relapsing multiple sclerosis
What is treated by interferon gamma
Chronic granulomatous disease, such as leprosy
What class is interferon alpha
anti-viral
When is interferon alpha used
For Chronic hepatitis B and C, genital warts due to HPV, Kaposi’s sarcoma and hairy cell leukemia
What is the function of pegylated interferon alpha
prolongs the life of interferon in the body, going from 3x per week to 1x per week
When treating hepatitis C, what is ribavirin given with
pegylated interferon
What is the most likely form of vaccine to confer lifelong immunity
live attenuated virus
What are the toxoid vaccines
botulism and tetanus
What are the recombinant vaccines
HPV and Hep B
What is the live attenuated influenza vaccine (LAIV)/ fluMist
it is a nasal spray for healthy individuals
For whom is LAIV contraindicated
those with chronic health problems or pregnant women
What HPV types do vaccines protect against
HPV-16 and HPV-18
What HPV types does gardasil protect against
6 and 11, in addition to the standard 16 and 18
what vaccine is important in some who has lost his spleen or has diminished splenic activity
pneumococcal vaccine
For whom are all vaccines contraindicated
Those who are immune-suppressed (HIV/AIDS, anti-rheumatoid meds, steroids)
When should someone be revaccinated with pneumococcal vaccine
Once they hit age 65. Revaccination at periodic intervals is also indicated for those with other conditions such as asplenia or nephrotic syndrome
