Anti-Viral Therapy ✅ Flashcards

1
Q

What are the limitations of anti-viral therapy?

A
  • Hard to achieve drug anti-viral selectivity

- Virus often widespread before symptoms present and treatment initiated

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2
Q

Why is drug anti-viral selectivity harder to achieve than for anti-bacterial drugs?

A

Viral replication depends on host cellular processes

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3
Q

What do anti-viral agents target?

A

Different stages in virus-specific replication

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4
Q

What stages in virus-specific replication can be targeted by anti-virals?

A
  • Entry into the cell
  • Transcription
  • Nucleic acid and protein synthesis
  • Package and release of virions
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5
Q

Of what type are most anti-virals in clinical use?

A

Nucleoside analogues

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6
Q

How do nucleoside analogues work?

A

They look like the basic nucleotides, but have been chemically altered to stop viral replication

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7
Q

How is aciclovir able to induce selective toxicity against viruses?

A

Because it is a pro-drug which requires viral enzyme to help convert it to the active form

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8
Q

How is aciclovir converted to the active form?

A

By phosphorylation

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9
Q

What is aciclovir used to treat?

A
  • Herpes simplex virus (HSV)

- VZV

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10
Q

How is valaciclovir administered?

A

Orally

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11
Q

What happens once valaciclovir is absorbed into the blood?

A

It becomes hydrolysed to aciclovir

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12
Q

What is gangciclovir used to treat?

A

CMV

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13
Q

Why is ganciclovir specifically used to treat CMV?

A

It requires phosphorylation using an enzyme present in CMV

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14
Q

How does the toxicity of ganciclovir compare to aciclovir?

A

It is more toxic

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15
Q

Why is ganciclovir more toxic than aciclovir?

A

Host cells can also add the phosphate group to ganciclovir

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16
Q

What is the difference between valganciclovir and ganciclovir?

A

Valganciclovir is better absorbed orally

17
Q

What anti-viral is active against influenza?

A

Oseltamivir

18
Q

How is oseltamivir active against influenza?

A

It inhibits newly formed influenza virions from being released from host cells

19
Q

How does oseltamivir inhibit the release of newly formed influenza virions?

A

By inhibiting viral neuraminidase (surface proteins)

20
Q

What kind of anti-virals are used to treat HIV?

A

Antiretrovirals

21
Q

What are the classes of anti-retrovirals?

A
  • Nucleoside analogue reverse transcriptase inhibitiors (NRTs)
  • Non-nucleoside analogue reverse transcriptase inhibitors (NNRTs)
  • Protease inhibitors (PI)
  • Fusion inhibitors (FI)
  • Integrase inhibitors
22
Q

Give an example of a NRTI

A

AZT

23
Q

Give an example of a NNRTI?

A

Nevirapine

24
Q

Give an example of a protease inhibitor

A

Ritonavir

25
Q

Give an example of a fusion inhibitor

A

Maraviroc

26
Q

Give an example of a integrase inhibitor

A

Raltegravir

27
Q

What can limit the tolerability of antiretrovirals in HIV?

A

Side effects

28
Q

How do protease inhibitors exert their side effects?

A

By affecting glucose and lipid metabolism

29
Q

What can lead to drug resistance against antiretrovirals used in HIV?

A

Mutations in the virus

30
Q

How is resistance to anti-retrovirals in HIV prevented?

A
  • Combination treatment

- Good adherence