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MD3001 - Respiratory Pharmacology and Treatment > Anti-Viral Drugs > Flashcards

Anti-Viral Drugs Flashcards

1
Q

What are viruses?

A

small infective agents consistening of nucleic acid (RNA or DNA) enclosed in a protein coat.

They are not cells as they have no metabolic machinery of their own; obligate intracellular parasites

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2
Q

What viruses contain double stranded DNA?

A
  • Herpes virus
  • poxvirus
  • adenovirus
  • hepadnavirus
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3
Q

What viruses contain single stranded DNA?

A
  • parvovirus
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4
Q

What viruses contain positive single stranded RNA?

A
  • piconaviridae
  • calicivirus
  • togavirus and flavivirus
  • coronavirus
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5
Q

What viruses contain negtaive single stranded RNA?

A
  • Paramyxoviridaw
  • Orthomyxoviridae
  • Arenvirus
  • Rhabdovir dae
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6
Q

What viruses contain positive ssRNA that is converted to DNA?

A

retroviruses

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7
Q

What viruses are common in the brain?

A
  • HSV
  • rabies
  • picronaviruses
  • HIV
  • measles
  • mumps
  • toga
  • falvi
  • encephalitis viruses (tropical diseases)
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8
Q

What viruses are common in the eyes?

A
  • HSV
  • adenovirus
  • measles
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9
Q

What viruses are common in the nose?

A
  • Common cold
    • rhinovirus
    • influenzas
    • coronavirus
    • RSV
    • adenovirus
    • parainfluenza
  • Pharyngitis
    • adenovirus
    • HSV
    • EBV
    • coxachie virus
  • Lower respiratory
    • influenza
    • parainfluenza
    • RSV
    • adenovirus
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10
Q

What viruses are common in the enteric system (intestines)?

A
  • rotavirus
  • Norwalk
  • Adenovirus
  • picornaviruses
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11
Q

What viruses are common in the urogenital system?

A
  • HSV
  • papilloma
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12
Q

What viruses are common in the lymphoid system?

A
  • EBV
  • CMV
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13
Q

What viruses are common in the liver?

A
  • hepatitis
  • yellow fever
  • CMV
  • EBV
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14
Q

What viruses are common in the heart?

A
  • coxachie virus
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15
Q

What viruses are common in the skin and mucous membranes

A
  • HSV
  • VZV
  • measles
  • rubella
  • papilloma
  • B19 parvorius
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16
Q

What viruses are common in the mouth?

A

HSV and coxachie virus

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17
Q

Describe viral replication

A
  • viruses have no metabolic machinery
  • attach to and enter a living host cell-animal. Binding sites on the virus are polypeptides in the envelope or caspid
  • virus attaches to normal receptors on the host cell and enters the cell by endocytosis or another by pass route
  • once in the host cell the nucelic acid of the virus then uses the cell’s machinery for synthesising nucleic acid and protein and the manufacture of the new virus particles
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18
Q

What are the 9 processes in the virus life cycle that can be targeted by anti-viral drugs?

A
  1. recognition
  2. attachment
  3. fusion and penetration
  4. uncoating
  5. transciption
  6. protein synthesis
  7. replication
  8. assembly
  9. lysis/budding and release
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19
Q

How do nucleoside/nucelotide analogues work?

A

They are compounds with a very similar structure to human nucelotides so act by taking the place of standard nucelotides we use to build DNA

This means they block the building/synthesis of the DNA chain

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20
Q

What are the two types of reverse transciptase inhibitors? And how many in each category are approved for use?

A
  • Nuceloside analogues (NRTIs) = 8
  • Non-nuceloside anagloues (NNRTIs) = 4
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21
Q

How does a NRTI work?

A

inhibit viral DNA synthesis by acting as a chain termination

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22
Q

How does a NNRTI work?

A

Binding induces a conformational change that inhibit the catalytic activity of reverse transcriptase

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23
Q

What are the main NRTIs?

A
  1. abacavir
  2. didanosine
  3. emtricitabine
  4. stavudine
  5. lamivudine
  6. tenofovir
  7. zalcitabine
  8. zidovudine
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24
Q

What are the main NNRTIs?

A
  1. delavirdine
  2. efavirenz
  3. etravirine
  4. nevirapine
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25
Q

What are the 2 main protease inhibitors avalible for use in treating HCV?

A
  • Telaprevir
  • Boceprevir
26
Q

What are the 2 main DNA viruses?

A
  • herpes simplex virus (HSV)
  • Human papilloma virus (HPV)
27
Q

What is the general mechanism of DNA viruses?

A
  • entry of the viral DNA into the host cells nucleus
  • transciprtion of this viral DNA into mRNA by the hosy cell RNA polymerase
  • followed by translation of the mRNA into virus-specific proteins
28
Q

What drug is used in the treatment of herpres sumplex virus and varicella zoster virus?

A

Aciclovir

29
Q

What are the main uses of aciclovir?

A
  • genital herpes simplex
  • herpes simplex lavialis (cold sores)
  • shingles
  • acute chicken pox in immunocompromised patients
  • herpes simplex encephalitis
  • Acute mucocutaneous HSV infections in immunocompromised patients
  • herpes of the eye and herpes simplex blepharitis (eye)
30
Q

What is not reduced by aciclovir?

A

PAIN

31
Q

What are the other main drugs that can be used to treat herpes? And what is the main indication for these drugs?

A
  • valaciclovir = a prodrug with better oral availability
  • CMV: aciclovir not as active

Indication = compromised patients

32
Q

What are the main RNA viruses?

A

Influenza (Flu), Hepatitis C Virus (HCV)

33
Q

What are RNA viruses classified by?

A

according to the sense or polarity of their RNA

34
Q

What is positive-sense RNA?

A

similar to mRNA and can be immediately translated by the host cell

35
Q

What is negative sense RNA?

A

is complementary to mRNA and must be converted to positive-sense by an RNA polymerase before translation.

36
Q

What directs the synthesis of more viral genomic RNA?

A

RNA polymerase

37
Q

Where does virus replication of RNA viruses usually occur?

A

Cytoplasm

38
Q

What are the main retroviruses?

A

HIV, Human T cell leukaemia virus (HTLV)

39
Q

What is the action of retroviruses?

A
  • virus contains reverse transcriptase and RNA-dependent DNA polymerase, which makes a DNA copy of the viral RNA
  • DNA copy is intergrated into the genome of the host cell and is called a provirus
  • provirus DNA is transcribed into both new genomic RNA and mRNA for translation into viral proteins using host cell machinery
40
Q

What is zidovudine (AZT) an analogue of?

A

thymidine

41
Q

What is abacavir (ABC) an analogue of?

A

guanosine

42
Q

What is lamivudine (3TC) an analogue of?

A

cytosine

43
Q

What is didanosine (ddl) an analogue of?

A

deoxyadenosine

44
Q

What is zalcitabine (ddC) an analogue of?

A

cytosine

45
Q

What is stavudine (d4T) an analogue of?

A

thymidine

46
Q

How do nucleoside/nucelotide analogues work as anti-viral drugs?

A
  • compete with natural substrate in DNA or RNA polymerisation
  • Act as chain terminators by not offerinf the 3’-hydroxyl function, which is a requirement for incoming nucelotide binding
47
Q

What do prodrugs require?

A

intracellular phosphorylation by viral and/or cellular kinases to cinvert them from 5’-monophosphate form to the 5’-triphosphate

48
Q

How do protease inhibitors prevent viral replication?

A
  • most mRNAs code directly from their functional proteins
  • mRNA is translated into biochemically inert proteins
  • A virus specific protease then coverts them into functional proteins
  • A protease inhibitor simply prevents this process from occuring
49
Q

What are the main protease inhibitors?

A
  • amprenavir
  • atazanavir
  • darunavir
  • fosamprebavir
  • indinavir
  • lopinavir
  • nelfinavir
  • ritonavir
  • saquinavir
  • tipanavir
50
Q

What 2 reactions does HIV integrase madiate

A

3’ end processing of the double-stranded viral DNA ends and then strand transfer which joins the viral DNA to the host chromosomal DNA forming a functionally integrated provirus.

51
Q

What are the main intergrase inhibitors?

A
  • raltegravir
  • dolutegravir
  • Used in concurrent HAARt therapy
52
Q

What is the action of fusion inhibitors?

A

Entry of HIV into a new cell is mediated by the Env glycoprotein spike a trimer of gp120 and gp41. Entry requires the receptor CD4 plus one of two co-receptors, CCR5 or CXCR4.

53
Q

Example of a fusion inhibitor

A

Maraviroc

Enfurviritide

54
Q

What is HAART?

A

Highly active antiretroviral therapy

55
Q

What is atripla

A

2 NTRIs

1 NNRTI

Low cost fixed generic dosw

56
Q

What are the main inhibitors of attachement to or penetration of host cells?

A

Amantadine and rimatadine

57
Q

What is the mechanism of Amantadine & Rimantadine

A

At two stages of viral replication within the host cell, a viral membrane protein, M2, functions as an ion channel. The stages are (i) the fusion of viral membrane and endosome membrane and (ii) the later stage of assembly and release of new virions at the host cell surface. Amantadine blocks this ion channel.

58
Q

What type of drugs are Amantadine & Rimantadine

A

M2 ion channel inhibitors

59
Q

What are the main influenza inhibitors? and what is their mechanism of action

A

Tamiflu and Relenza

Neuraminidase (NA) inhibitors

60
Q

How does neuraminidase work in influenza?

A

functions in Influenza infection by cleaving sialic acid from the cell surface so that newly made viruses are released and able to spread to uninfected cells.

NA inhibitors mimic the sialic acid natural substrate by binding to the NA active site, preventing NA function and hence halting virus replication.

61
Q

What drugs are used in the treatment of hepatitis C?

A
  • Ribavirin
  • Peginterferon alpha
  • Simeprevir Ledipasvir and sofosbuvir

• Protease inhibitors (grazoprevir, glecaprevir paritaprevir)

62
Q

What is Immunomodulator PEG-IFN-α used in the treatment of?

A

HCV and HBV

MD3001 - Respiratory Pharmacology and Treatment (6 decks)

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