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Pharm 225B > Anti-Virals > Flashcards

Anti-Virals Flashcards

1
Q

Anti-tuberculosis Agents (5)

A
  • Isoniazid (INH)
  • Rifampin
  • Rifapentine
  • Pyrazinamine
  • Ethambutol

*all PO

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2
Q

Isoniazid (INH) use/moa

A
  • bactericidal activity in TB treatment
  • MoA: inhibits synthesis of mycobacterial wall
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3
Q

Isoniazid (INH) AEs/BBW

A
  • AEs: peripheral neuropathy (reduce with Vit B6)
  • BBW: severe hepatitis & potent CYP inhibitor
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4
Q

Rifampin/rifapentine use/moa

A

*rifapentine is long acting analog of rifampin
- bactericidal activity in TB treatment
- MoA: inhibits RNA synthesis by blocking RNA transcription

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5
Q

Rifampin/rifapentine AEs

A
  • hepatotoxicity
  • red/orange body secretions that stain
  • potent CYP inducer
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6
Q

Pyrazinamine use/moa/AEs

A
  • bactericidal activity in TB treatment
  • MoA unknown
  • AEs: hepatotoxicity
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7
Q

Ethambutol use/Moa

A
  • bacteriostatic activity in TB treatment
  • MoA unknown
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8
Q

choice of drugs for uncomplicated, LATENT TB

A
  • INH 6-9 months
  • Rifampin 4 months
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9
Q

choice of drugs for uncomplicated, ACTIVE TB

A

*think RIPE
- Rifampin
- INH
- Pyrazinamide
- Ethambutol

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10
Q

drugs for herpes simplex virus (HSV 1& 2) & varicella zoster virus (VZV) (2)

A
  • Acyclovir (PO, IV, topical) *prototype
  • Valacyclovir (PO) *prodrug of acyclovir
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11
Q

Vala/Acyclovir MoA

A
  • inhibition of viral replication by inhibiting viral DNA polymerase/incorporation of growing viral DNA strand –> no viral DNA synthesis
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12
Q

Vala/Acyclovir side effects (not AEs)

A
  • malaise, headache, N/V/D
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13
Q

Vala/Acyclovir specifically treats what for HSV/VZV

A

HSV-1 –> prevent cold sores
HSV-2 –> reduce severity and frequency of genital herpes (does not eliminate)
VZV –> chicken pox and shingles

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14
Q

Valganciclovir use/moa

A
  • prevention and treatment of cytomegalovirus (CMV)
  • (same MoA as acyclovir) inhibition of viral replication by inhibiting viral DNA polymerase/incorporation of growing viral DNA strand –> no viral DNA synthesis
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15
Q

drugs for Hep C (5ish)

A
  • Interferon alpha 2a & 2b
  • Ribavirin
  • NS3/4A serine protease inhibitors
  • NS5A serine protease inhibitors
  • NS5B inhibitors
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16
Q
  • Interferon alpha 2a & 2b route/moa
A
  • subQ
  • MoA: binds receptors on HOST cell membranes to block VIRAL entry, viral mRNA/proteins synthesis and release
    *used in combo with ribavirin for Hep C tx
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17
Q
  • Interferon alpha 2a & 2b advantage/AEs/BBW
A
  • long half life, admin only 1xs/week
    AEs:
  • flu like syndrome
  • depression/suicide
  • combo use may cause birth defects
    BBW: cause/worsen autoimmunes, infections, ischemic events
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18
Q

Ribavirin route/MoA

A
  • PO but used in combo with Interferon alpha 2a & 2b
  • MoA: inhibits Hep C virus polymerase activity –> no viral RNA replication
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19
Q

Ribavirin AE/BBW

A
  • hemolytic anemia within first 2 weeks of tx
  • BBW: significant teratogenic effects, avoid in pregnancy
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20
Q

NS3/4A serine protease inhibitors drugs/route (2)

A

*end in -previr
- Simeprevir - PO
- paritaprevir - PO

21
Q

Simeprevir/paritaprevir MoA/indication

A
  • MoA: inhibit NS3/4A serine protease –> prevent HCV replication and maturation
  • indication: chronic HCV in combo with other agents
    *NOT as monotherapy
22
Q

Simeprevir/paritaprevir AEs

A

fatigue, N/V, anemia, headache, severe rash

23
Q

NS5A serine protease inhibitors drugs/route (2)

A

*end in -Asvir
- ombitAsvir - PO
- ledipAsvir - PO

24
Q

OmbitAsvir usually used in combo with..

A

paritaPrevir + ritonavir

25
Q

LedipAsvir usually used in combo with..

A

sofosBuvir

26
Q

OmbitAsvir/LedipAsvir MoA/Indications

A
  • MoA: inhibit NS5A serine protease –> no HCV maturation
  • treat chronic HCV in combo with other HCV drugs
    *NOT for monotherapy
27
Q

OmbitAsvir/LedipAsvir AEs

A
  • headache, fatigue, N/V, anemia
28
Q

NS5B inhibitor drug/route

A

*ends in -Buvir
- SofosBuvir (prodrug converted in liver)
- PO

29
Q

SofosBuvir MoA/indication

A
  • MoA: HCV NS5B polymerase inhibitor
  • indication: first line agent in combo with other HCV drugs
    *NOT for monotherapy
30
Q

SofosBuvir AEs

A
  • fatigue
  • diarrhea
  • anemia
  • Headache
31
Q

classes of meds for HIV tx (highly active antiretroviral treatment) (6)

A
  • nucleoside/tide RTIs (NRTIs)
  • non-nucleoside RTIs (NNRTIs)
  • protease Inhibitors (PIs)
  • integrase strand transfer inhibitors (INSTI)
  • HIV fusion inhibitor
  • CCR5 Antagonists
32
Q

NRTIs drugs/route/moa

A
  • all PO
  • Emtricitabine
  • Tenofovir
  • blocks incorporation of viral DNA by preventing reverse transcriptase to add more bases
33
Q

NRTIs AE/BBW

A
  • pruritus, rash
  • BBW: lactic acidosis, severe hepatomegaly
34
Q

NNRTIs drug/route/moa

A

*PO
- Efavirenz

  • direct inhibition of HIV reverse transcriptase
35
Q

NNRTIs AEs

A
  • Erythema, rash, SJS
  • Liver failure
  • depression, psychosis, suicidal thoughts
  • teratogen –> avoid in pregnancy
36
Q

Protease Inhibitor (PI) drug/route/moA

A
  • Ritonavir - PO
  • Inhibits HIV protease –>prevent maturation of HIV
37
Q

Ritoniavir (PI) AEs

A
  • AV block, prolonged PR interval
  • hyperglycemia, hypercholesterolemia
  • pancreatitis
  • hepatitis, hepatotoxicity
  • immune hypersensitivity reaction
  • SJS
  • BBW: co admin w/ hypnotics, anti-arrythmics/ergot derivatives –> life threatening AEs due to CYP enzyme inhibition
38
Q

INSTI drug/route/moa

A
  • Elvintegravir
  • PO
  • Inhibit HIV integrase –> prevent viral DNA integration into human nucleus and DNA
39
Q

HIV fusion inhibitor drug/route/moa

A
  • Enfuvirtide
  • Sub Q
  • Prevent HIV infusion with lymphocyte cell membrane –> block HIV entry and replication
40
Q

CCR5 Antagonist drug/route/moa

A
  • Maraviroc
  • PO
  • binds CCR5 receptor –> blocks viral entry
41
Q

HIV regimens (3 general types, at least 3 meds in each)

A
  • NNRTI based (1 NNRTI + 2 NRTIs)
  • INSTI based ( INSTI + 2 NRTIs)
  • Boosted PI (PI + 2 NRTIs)
42
Q

Neuraminidase inhibitor drugs/routes (3)

A

*ends in -mivir
- Oseltamivir - PO
- Zanamivir - Inhalation
- Peramivir - IV

43
Q

Neuraminidase inhibitor Moa/AE

A
  • MoA: inhibits neuraminidase (enzyme requires for viral replication); active against influenza A, B & H1N1
  • AE: N/V –> give with food to avoid
44
Q

Baloxavir MoA/AEs

A
  • MoA: selectively inhibits endonuclease function in the polymerase acidic proteins, that are essential for viral replication
  • AEs: diarrhea, bronchitis, nausea, sinusitis, headache
45
Q

Approved COVID19 drugs/routes (3)

A
  • Tocilizumab - IV/SubQ
  • Remdesivir - IV
  • Baricitinib - PO
46
Q

Tocilizumab MoA/Indication

A
  • MoA: binds to IL6 receptors, inhibits IL6 inflammatory pathways
  • Ind: hospitalized COVID adults, on corticosteroids, supp. O2, mechanical ventilation, or ECMO
47
Q

Remdesivir MoA/Indication

A
  • MoA: a direct acting antiviral that inhibits viral RNA synthesis
  • Ind: tx for COVID adults/peds, in or out of hospital, with mild-moderate COVID and are at high risk for severe progression (hospitalization or death)
48
Q

Baricitinib MoA/Indication

A
  • MoA: JAK inhibitor, reduces IL6 inflammatory responses; directly interfere with endocytosis of SARS-CoV-2 into susceptible cells
  • Ind: tx for COVID adults in hospital on supp. oxygen, mechanical ventilation, or ECMO
49
Q

Paxlovid (nirmatrelvir + ritonavir) indication/MoA

A
  • emergency antiviral used for tx of adults/peds with mild-moderate COVID
  • MoA: nirmatrelvir inhibits required breakdown of viral proteins necessary for viral replication;
    Ritonavir increases the effect of nirmatrelvir via CYP3A4 inhibitions

Pharm 225B (9 decks)

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