Anti-viral drugs Flashcards
Acyclovir is used against what viral pathogens?
HSV-1 and HSV-2
Ganciclovir and Foscarnet for what viral disease?
CMV
What drug gets monophosphorylated by a viral thymidine-kinase (TK), then converted to nucleotide analogs (triphosphorylated form) by host cell kinases?
Acyclovir
Acyclovir-triphosphate is both a substrate for and inhibitor of viral _______-polymerase
DNA
When incorporated into the DNA molecule, acts as a chain terminator except what drug?
Famciclovir
What two problems is Acyclovir the drug of choice?
Ophthalmic preparation is used to treat herpes simplex dendritic keratitis Topical application for mucocutaneous herpetic infections in immunocompromised patients
What drug reduces symptoms if used early in chickenpox Decrease acute neuritis in shingles but has no effect on post herpetic neuralgia (PHN)?
Acyclovir
What are the ADR for Acyclovir?
GI problems, Nephrotoxicity, Neurotoxicity, not hematotoxic
What drug causes chain termination like acyclovir?
Ganciclovir
What does Ganciclovir cause that Acyclovir does not, and why is that?
Hematotoxicity, Ganciclovir can be phosphorylated by a number of different kinases
Foscarnet is not a what?
Antimetabolite and nucleoside analog
What is the mechanism of action of Foscarnet? What is Foscarnet used for via if resistance is an issue?
Inhibits viral DNA and RNA polymerase Acyclovir-resistant strains of HSV
What are the adverse drug reactions of Foscarnet? How must the drug be given and where can the drug reach?
Pentamidine
Nephrotoxicity, hypocalemia, and arrhythmias CNS and given IV
A HIV patient develops CMV retinitis. Which drug would you give?
Ganciclovir
If a patient develops Pneumocystis carinii pneumonia (PCP), which drug would u give?
Cotrimoxazole
Cotrimoxazole + Ganciclovir can cause what problem? What is the alternative drug?
Bone Marrow Foscarnet
If you cannot give cotrimoxazole due to bone marrow suppression, then to treat PCP you have to give what? (answer is not an anti-viral drug)
Pentamidine
Pentamidine and Foscarnet cannot be given together due to what?
Heavy nephrotoxicity
Besides acyclovir, what drug is converted by cellular enzymes to its triphosphate analog, which inhibits viral DNA synthesis? not a -cyclovir drug
Trifluridine
What three viruses can Trifluridine impact? Besides acyclovir resistant what else does Trifluridine treat?
HSV-1, HSV-2, and VZV Ocular HSV infections
How does Cidofovir inhibit DNA polymerase?
No Phosphorylation converted by cellular analogs, DNA and RNA polymerase inhibition
What drug is given with Cidofovir and fluids in order to prevent what?
Nephrotoxicity probenecid: increases uric acid secretion
Gancyclovir is very important against what versions of Herpes?
CMV
What does Foscarnet do? What is an ADR? Who/what people are these drugs worked on?
Directly inhibits viral DNA and RNA polymerase Nephrotoxic, hypocalemia, and arrhythmia Acyclovir Resistant
What is trifluridine’s mechanism of action?
convert trifluridine to a tri-phosphate analog, prevent nucleotide chain elongation
What does Zanamivir inhibit? (Antiviral) How is it given?
Neuraminidase Intranasal and inhalation
Ribavirin inhibits what in viral replication? (IMP, biochemistry) The tri-phosphate form stops what?
Purine Replication, stops IMP Viral RNA Polymerase and end capping
Ribavirin can be paired with alpha interferons to treat what disease? What are two complications?
Hep. C
Teratogenic, Upper airway irritation
What is a novel drug against RSV?
What type of newborn infants can receive treatment from this drug because of the overarching complications?
Palivizumab Bronchopulmonary Dysplasia
What are the most common side effects of interferon therapy? Name three
Flu like symptoms, Granulocytopenia, and Thrombocytopenia
Lamivudine is used against what two viruses?
What is it an analog for?
Hepatitis B and HIV
Cytosine
What drug is used when the body becomes resistant to Lambivudine?
Entecavir
What drug is used against HBV, can be used for a nucleoside analog (adenosine)?
Tenofovir
What do Entecavir and Emtricitabine treat, viral infection?
Hepatitis B
Except for lamivudine and _______, all the NRTIs have been associated with a potentially fatal liver toxicity characterized by lactic acidosis and___________
abacavir
hepatomegaly
Cimetidine, indomethacin, probenecid increase ___________toxicity. (Nucleotide Reverse Transcriptase Inhibitor)
Serious myelosuppression (neutropenia): if given along with Ganciclovir, _________
Zidovudine and ______ should not be combined because they have an antagonistic effect
AZT
Cortrimoxazole
Stavudine
AZT and Acetaminophen given together can cause what?
Hepatotoxicity
Didanosine is known for what type of toxicity?
Didanosine increases the risk for pancreatitis, neuropathy, and lactic acidosis when combined with what drug?
Tenofovir and Didanosine should not be combined for what reason?
Pancreatic toxicity
Stavudine
Pancreatitis and lactic acidosis
When is Abacavir used?
Is what type of nucleoside analog?
- used when other treatments fail or not tolerated.
- Occasional fatal hypersensitivity reactions
- Skin rashes and respiratory distress are common
Guanosine analog
Tenofovir is what type of an analog?
Typically used in HIV treatment, can be used in what other types of treatment?
What are the most common side effects?
Adenosine
Chronic Hep B
GI, Renal Dysfunction
________________is a fluorinated analog of lamivudine with a long half-life that allows for once-daily dosing.
Emtricitabine
What type of HIV drug is metabolized very quickly via the p450 system?
NNRTIS
Also effective in reducing vertical transmission of HIV from mother to fetus when used as monotherapy, what HIV drug?
What are two big drug reactions?
Nevirapine
Severe Hepatoxicity and Steven Johnson Syndrome
What is the inducer of p450, NNRTI, 1/2 life of 40 hours?
CNS effects and teratogenic
Efavirenz
What type of HIV drug allows drug clearence of the immature viron?
What type of enzyme system does this drug class inhibit?
Protease inhibitor
CYP450
The protease inhibitor have what typical ending?
-navir
Atazanavir
What type of system does Ritonavir inhibit?
Idinavir can cause what if there is not proper hydration?
Protease inhibitor
(CYP 450)
Nephrolithiasis
Raltegravir is an inhibitor of what enzyme that is necessary for HIV proliferation?
Integrase
Enfuvirtide binds to what to prohibit HIV replication?
gp41