Brainscape's Knowledge GenomeTM

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


See full index

Pharm Exam 3 > Anti Viral > Flashcards

Anti Viral Flashcards

1
Q

3 main Anti HSV/VZV drugs

A

acyclovir
valacylovir
famciclovir

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

what anti-HSV drug is IV

A

acyclovir

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

MOA for Anti HSV/VZV drugs?

A

competes w/ deoxyguanosine for viral DNA polymerase & goes into viral DNA to terminate the DNA chain

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

MOR for Anti HSV/VZV drugs?

A

alters binding site

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

how fast should you intiate Anti HSV/VZV drugs?

A

w/ in 24-72hrs

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

which Anti HSV/VZV drug has poor bioavailability?

A

acyclovir

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

indications for acyclovir

A

primary/recurrent genital HSV
orolabial HSV
Encephalitis
Primary & secondary VZV

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

ADR of acyclovir

A

large IV doses can cause crystalline nephropathy with reversible AKI

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

indications of valacyclovir

A

primary and recurrent genital HSV

secondary VZV

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

what is the special use of valacyclovir in prim or secondary genital HSV?

A

can suppress clinical and subclinical shedding 50-60%, to prevent transmission to seronegative partners

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

why is valacyclovir more bio available than acyclovir?

A

b/c its prodrug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the twin of valacyclovir in indication and ADR?

A

famciclovir

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

ADR of valacyclovir?

A

well tolerated

HA = most common

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

when does CMV reactivation occur

A

transplant pts

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

3 anti EBV/CMV drugs

A

ganiciclovir
valganciclovir
letermovir

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

how much more potent is ganciclovir than acyclovir?

A

10x

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

indications for ganciclovir?

A

active retinitis
suppression of retinitis
colitis, esophagitis
prevention of CMV in transplant pts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

ADR of ganiciclovir?

A

bone marrow suppression (neutropenia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Valganciclovir is the prodrug of what?

A

ganiciclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

clinical indications of valganciclovir

A

induction and maintenance of CMV retinitis

prevention of CMV post transplant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

ADR of valganciclovir

A

bone marrow suppression (neutropenia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

letermovir clinical indications

A

prophylaxis of CMV infection & dz in CMV + adults w/ allogenic HCT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

ADR of letermovir

A 
N/V/D
Cardiac ADR (tachy/a-fib)
Testicular toxicity (only in rats?)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

how does letermovir work?

A

CMV DNA terminate complex inhibitor–prevents Viral DNA processing and packaging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

does letermovir work against non-CMV viruses?

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

who gets antiviral influenza tx (susp. or confirmed influenza)?

A

hospitalized pts
severe/complicated illness
high risk for complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what are the 2 amantanes/M2 inhibitors?

A

amantadine

rimanatadine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

MOA of amantadine/rimantadine

A

block viral uncoating of influenza A–preventing viral penetration into host

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

when does amantadine/rimantadine need to be given to be effective?

A

w/ in 48hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

other uses of amantadine

A

tx parkinsonism

tx of drug induced EPS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

ADR of amantadine/rimantadine

A

teratogen in animals

-CNS dominant; nervousness, anxiety, light headed, confusion, insomnia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

3 neuraminidase inhibitors

A

oseltamivir
zanamivir
peramivir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

formulation of permivir

A

IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Oseltamivir MOR

A

AA alteration in binding site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

clinical use of oseltamivir

A

chemoprophylaxis of influ. A&B, swine & avian influenza
tx of influ. A&B (>2 wks old)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

who gets oseltamivir for influ. A & B PROPHYLAXIS

A

unvacc ppl @ risk for flu complications
unvacc HCW w/ exp
outbreak in NH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

how does oseltamivir treat influ A&B?

A

decreases severity and duration of symptoms

decreases LRTI complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

how long do you treat flu w/ oseltamivir

A

5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

who is at risk for influenza complications?

A 
<2 y/o
>65 y/o
chronic cardiopulm disorders (asthma, HF)
pregnancy or post partum (<2wks)
<19 on ASA therapy
American indian/alaskan native
BMI >40
NH resident
pts w/ metabolic dz
pts w/ auto-immune dz
pts w/ NM disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what bacteria often accompanies viral pneumonia w/ influenza?

A

strep pneumo or s. aures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

dose of oseltamivir

A

75 mg PO BID x 5 d

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

ADR in kids of oseltamivir?

A

neuropsych events (self injury, confusion, delirium)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Zanamivir ADR

A

nasal/throat discomfort

bronchospams (asthma/COPD pts)

44
Q

what does zanamivir fight?

A

viruses that are amantadine/rimantadine resistant & oseltamivir-resistant influenza strains

45
Q

what drug is a Polymerase Acidic Endonuclease Inhibitors?

A

Baloxavir

46
Q

MOA of Baloxavir

A

inhibits Cap-dependent endonuclease activity to prevent viral replication

47
Q

what is Baloxavir effective against?

A

influenza A&B including NA inhibitor resistant strains

48
Q

can you use Baloxavir for prophylaxis?

A

no

49
Q

when should Baloxavir been started

A

w/ in 48hrs

50
Q

what should you avoid taking when on Baloxavir

A

multivalent cations

51
Q

what are the old antiretroviral classes

A

NRTI
NNRTI
Protease inhibitors

52
Q

what are the new antiretroviral classes

A

fusion inhibitors
entry inhibitors
integrase inhibitors
post-attachment inhibitors

53
Q

MOA of NRTI

A

interfere w/ HIV viral RNA dependent DNA polymerase to inhibit viral replication

54
Q

what do NRTI induce?

A

mitochrondial dysfunction

55
Q

what are clinical manifestations of NRTI on mitochorndia?

A 
neuropathy
myopathy
CMP
pancreatitis
hepatic stenosis
lactic acidosis
56
Q

what are the ADRs of Zidovudine (AZT)

A

anemia
neutropenia
hyperpigmentation of oral mucosa and nailbed

57
Q

what are the ADRs of Stavudine (d4T)?

A

pancreatitis

peripheral neuropathy

58
Q

what are the NRTI thyaimne analogs?

A

Zidovudine

Stavudine

59
Q

what are the NRTI cytosine analogs? what extra activity do they have?

A

lamivudine (3TC)
Emtricitabine (FTC)
*HBV+ activity

60
Q

ADR of lamivudine and Emtricitabine

A

none

-well tolerated

61
Q

what are the NRTI adenine analogs?

A

didanosine (ddl)

Tenofovir (TDR–>TAF)

62
Q

what is special activity of tenovir?

A

HBV+ activity

63
Q

ADR of tenovir?

A

none

-well-tolerated

64
Q

ADRs of didanosine?

A

pancreatitis

peripheral neuropathy

65
Q

what is the NRTI guanine analog?

A

abacavir (ABC)

66
Q

ADRS of abacavir

A

hyperseensitivty rxn

67
Q

what HLA has hypersensitivty rxns to abacavir?

A

B*5701

68
Q

do we rechallange abacavir if they have a rxn?

A

NO

69
Q

what NRTI combo is approved to prevent HIV

A

TDF/FTC

70
Q

what is TAF/FTC/BIC

A

Biktarvy

71
Q

3 1st gen NNRTI’s

A

nevirapine (NVP)
Delavirdine (DLV)
Efavirenz (EFV)

72
Q

ADRs of nevairapine

A

hepatotoxicity

severe rash

73
Q

ADRs of efavirenz

A

teratogen
rash
*drug interactions
CNS disengagement (1-3hrs post dose)

74
Q

3 2nd gen NNRTI

A

Etravirine (ETR)
Doravirine (DOR)
Rilpivirine (RPV)

75
Q

what was rilpivirine designed for

A

activity against HIV w/ mutations that are resistant to NRTI

76
Q

ADR of 2nd gen NNRTI

A

severe rash

77
Q

MOA of NNRTI

A

block reverse transcriptase, to prevent DNA replication

78
Q

what is FTC/TDF/RPV

A

Complera

79
Q

what is the main Protease Inhibitor?

A

Draunavir

80
Q

MOA of Protease Inhibitors

A

bind to HIV protease to inhibit clevage of Gag-pol polyprotien precursor—form immature non-infectious viral particles

81
Q

what are ritonavir and cobi used for?

A

increasing conc. of PI

82
Q

what are drug interactions of COBI?

A

inhibitor of 3A4, 2D6, Pgp

*know statins, steroids, pde5 inhibitors, antiplatelets/ anticoagulatns, ABX, CCBs

83
Q

what do all PI’s have CYP interactions with?

A

3A4

84
Q

ADR of Protease Inhibitors

A

N/V/D
Hyperglycemia/insulin resistance/HLD
hepatoxicitiy
fat wasting

85
Q

which protease inhibitor is a sulfonylarlamine?

A

Darunavir

86
Q

what 4 drugs are integrase strand transfer inhibitors

A

ralegavir (RAL)
elevitegravir (EVG)
Dolutegravir(DTG)
Bictegravir (BIC)

87
Q

MOA of INSTI

A

inhibit integrase to prevent integration of proviral gene into human DNA

88
Q

if an HIV strand is resistant to ralte and elevite, what is it probably still susuceptible to?

A

dolutegravir

89
Q

ADR of INSTI

A

N/V/D

abd. pain

90
Q

what kind of a drug is Enfuvirtide

A

fusion inhibitor

91
Q

MOA of Enfuvirtide

A

bind to gp41 subunit of viral envelope glycoprotein–inhibits fusion of HIV to CD4 cells

92
Q

what kind of drug is Maravioc?

A

entry inhibitor

93
Q

MOA of maraviroc

A

CCR5 antagonist–binds to chemokine corereceptors on CD4 cells = Cell entry blocked

94
Q

what kind of drug is Ibalizumab

A

Post-attachment inhibitor (CD4 monocolonal AB)

95
Q

MOA of Ibalizumab

A

blocks entry of HIV into CD4 cells to prevent transmission via cell-cell fusion

96
Q

when is Ibalizumab used?

A

MDR HIV

97
Q

when is Combined Anti-retroviral therapy iniated

A

dx of pt no matter the CD4 count

ASAP

98
Q

common CART?

A

2 NRTI + 1 INSTI or + PI (DRV)

99
Q

is CART therapy life long

A

yes

100
Q

what is a PEARL about pts when they start CART

A

they need to be ready–b/c nonadherance causes resistance issues

101
Q

who do we test for HCV?

A

pts 18-79 y/o

102
Q

1st line HCV drug

A

Sofosubvir-velpatasvir

103
Q

what can you not mix sofosubvir with?

A

amiodarone

104
Q

what alters velpatasvir absorption

A

H2RA/PPI

105
Q

ADR of Sofosubvir-velpatasvir

A

HA

fatigue

106
Q

what is the 2nd line HCV drug

A

Glecaprevir-pibrentasvir

107
Q

ADR of Glecaprevir-pibrentasvir

A

HA
fatigue
nausea

Pharm Exam 3 (2 decks)

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