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Pharm 4 > Anti-Viral > Flashcards

Anti-Viral Flashcards

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1
Q

Herpesvirus

A

DNA virus - encode on DNA polymerase (target)

Lytic phase - only time to treat

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2
Q

Drugs to treat Herpesvirus

A 
Acyclovir
Valacyclovir
Foscarnet
Ganciclovir
Valganciclovir
Trifluridine
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3
Q

MOA Acyclovir

A

nucleoside analog - requires phosphorylation by viral thymidine kinase
Competitive inhibitor of viral DNA Polymerase - chain termination

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4
Q

Oral vs IV Acyclovir

A

Oral - genital herpes, VZV

IV - severe/disseminated, neonatal, HSV encephalitis, VZV in IC

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5
Q

RES Acyclovir

A

mutation of thymidine kinase

Cross-resistance with other anti-virals of same mechanism

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6
Q

AE Acyclovir

A

mild; come nephrotoxicity and neurotoxicity

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7
Q

Valacyclovir

A

prodrug of Acyclovir; metabolized to Acyclovir
3-5x greater bioavailability
Indicated: primary/recurrent genital herpes, varicella in older children/adults, Zoster, orolabial herpes

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8
Q

MOA Foscarnet

A

pyrophosphate analog; blocks pyrophosphate release which blocks DNA polymerase
Does not require phosphorylation
Only IV administration

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9
Q

Indications for Foscarnet

A

HSV/VZV resistant to Acyclovir

Also: CMV, retinitis, colitis, esophagitis

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10
Q

AE Foscarnet

A

renal impairment - avoid nephrotoxic drugs

Blood ion changes

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11
Q

MOA Ganciclovir

A

requires phosphorylation by CMV UL97 - competitive inhibitor for DNA polymerase
IV administration; also oral, intraocular

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12
Q

RES Ganciclovir

A

mutation of CMV UL97

Cross-resistance with drugs of same mechanism

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13
Q

Indications for Ganciclovir

A

CMV retinitis, colitis, pneumonitis, esophagitis

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14
Q

AE Ganciclovir

A

Myelosuppression, BM/CNS toxicity, phlebitis, rash

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15
Q

Valganciclovir

A

prodrug of Ganciclovir
higher bioavailability
Indicated: CMV retinits, prevention of CMV disease in pts with heart, kidney pancreas transplant

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16
Q

MOA Trifluridine

A

requires phosphorylation

competitive inhibitor of thymidine for incorporation into genomes

17
Q

AE Trifluridine

A

Low selectivity = avoid systemic administration

Ocular to treat keratoconjunctivitis, keratitis (HSV 1/2)

18
Q

Influenza

A

segmented RNA virus from orthomyxovirus family

Serotypes A, B, C - high propensity for mutaiton

19
Q

MOA Oseltamivir

A

prodrug - metabolized to active compound by hepatic esterase

Inhibit neuraminidase - inhibit spread of progeny through respiratory tract

20
Q

RES Oseltamivir

A

point mutation in hemagglutinin or neuraminidase

21
Q

Indications for Oseltamivir

A

> 1
Influenza A/B - given w/in first 48h for uncomplicated
Complicated - give later than 48h

22
Q

Zanamivir

A

same as Oseltamivir
Inhaled to oropharynx/lungs
Children >7
AE - lung disturbances; contraindicated in pts with pulmonary disease

23
Q

Peramivir

A

Neuraminidase inhibitor
IV administration
Indicated for acute uncomplicated influenza (first 48h)
AE - rash, Steven-Johnson syndrome, hyperglycemia, HTN, CNS

24
Q

MOA Amantidine/Rimantidine

A

inhibit influenza A M2 protein - ion channel for nucleocapsid release

25
Q

Respiratory Syncytial Virus

A

enveloped RNA virus - paramyxovirus family
Most common cause of bronchiolitis/pneumonia in infants, elderly, IC
Common cold in adults/older children

26
Q

MOA Ribavirin

A

phosphorylated by cellular adenosine kinase
interferes with GTP synthesis
inhibit viral mRNA cappinginhibit RdRp of RSV and HCV

27
Q

Administration of Ribavirin

A

RSV - aerosol
HCV - oral in combination
Contraindicated in pregnancy, anemia, IVD, RD

28
Q

AE Ribavirin

A

hemolytic anemia, depression, fatigue

29
Q

HCV

A

RNA virus from flavavirus

Causes hepatitis - inflammation of liver - jaundice, diarrhea, ALT/AST, cirrhosis

30
Q

HCV Protease inhibitors

A

“PREVIR”

31
Q

HCV RNA polymerase inhibitors

A

“BUVIR”

32
Q

HCV NS5A Inhibitors

A

“ASVIR”

33
Q

Treatment of HCV

A

combination therapy with DAA

Ribavirin contraindicated in pregnancy

34
Q

HBV

A

DNA virus - uses reverse transcriptase
Causes hepatitis; chronic correlated with age of infx
Chronic infx has HBsAg and anti-HBc without anti-HBc IgM

35
Q

Pegylated Interferon

A

Recombinant cytokine - binds Jak/Stat

AE - flu-like SX, AI, neurotoxicity, myelosuppression

36
Q

Entecavir

A

Inhibits reverse transcriptase

AE - hematuria, lactic acidosis - not used for HIV

37
Q

Tenofovir

A

inhibits reverse transcriptase
AE - renal/bone toxicity, Fanconi syndrome, decreased fetal bone density/growth
Indicated in chronic Hep B and HIV

Pharm 4 (13 decks)

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