anti-virals Flashcards
moa of oseltamivir
inhibits influenze neuraminidase - decreases release of progeny viruses
moa of zanamivir
inhibits influenza neuraminidase - decreases release of progeny viruses
treatment of influenza A and B
oseltamivir
zanamivir
MIVIRs
prevention of influenza A and B
oseltamivir
zanamivir
MIVIRs
MOA of acyclovir/famciclovir, valacyclovir
guanosine analougs
monoPi by HSV/VZV thymidine kinase and not uninfected cells
triphosphate by host enzymes
inhibits viral DNA polymerase by chain termination
treatment of HSV and VZV
acyclovir, famciclovir, valacyclovir
what virsus foes acyclovir, famiciclovir and valacyclovir work against?
HSV, VZV, weak against EBV
NO CMV
treatment of HSV induced mucocutanoeus and genital lesiosn
acyclovir
famiciclovir
valacyclovir
treatment of HSV encephalitis
acyclovir
famiciclovir
valacyclovir
use of acyclovir in immunosuppressed indvls
prhophylaxis
doc at herpes zoster
famiciclovir
toxo of acyclovir
obstructive crystalline nephropathy
acute renal failure
how do prevent toxo of acyclovir
hydration to prevent obstructive crystalline nephropathy/acute renal failure
how do HSV and VZV resists acyclovir
muta viral thymidine kinase
moa fo ganciclovir
5’monophosphate formed by a CMV viral kinase
guanosine analog
triphosphate formed by cellular kinases
inhibits viral DNA polymerase by chain termination
doc of CMV, especially in immunocmopromised
ganciclovir
toxos of ganciclovir
leukopenia
neutropenia
thrombocytopenia
renal toxicity
which is more toxic to host cells, acyclovir of ganciclovir
ganvivclovir - leuko/neutron/thrombocytopenia
moa of resistane of ganciclovir
mutated viral kinase
moa of foscarnet
viral DNA/RNA polymerase inhibitor and HIV reverse transcriptase inhibitor
binds to pyroFOSphaste binding site
NO ACTIVATION BY KINASE REQUIRED
what is foscarnet used for
CMV retinitins when ganciclovr doesn’t work
acyclovir resistant HSV
toxo of foscarnet please
nephrotoxicity
electrolyte abnormalities: hypo/hyperCa AND hypo/hyperPO4 and hypoK and hypoMg
electorylte abnormalities can lead to seizures
MOA resistance foscarnet
mutated DNA plymerase
MOA cidofovir
preferentially inhibits viral DNA polymerase
DOES NTO REQUIRE PHOS BY KINASE
which two drugs for CMV do not require pi by kinase
foscarnet and cidofovir
what is the use of cidofovir
CMV retinitis in immunocompromised patients
acyclovir restiant HSV
toxo of cidofover
nephrotoxocity
how to prevent nephrotoxicity of cidofovir
give with probenecid and IV saline to decrease nephrotoxicity of cidofovir
how to treat HIV
three drug regimen to prevent resistance
2 x NRTIs and 1 x of a) NNRTI, b) integrase inhibitor or c( protease inhibitors
list the protease inhibitors
NAVIRS atazanavir darunavir fosamprenavir indinavir lopinavir ritonavir saduinavir
moa of preotease inhibitors
assumble of virions requires HIV-1 protease (pol gene) to cleave polypeptide of HIV mRNA into functional parts. so prevents maturation of new viruses
what makes ritonavir special?
inhibits P450 to boost other drug concentrations
common side effects of all protease inhibitors
hyperglycemia
lipodystrophy
nausea and diarrhoea
side effects of indinavir pelase
nephropathy
hematuria
proteas inhibitor that can cause nephropathy and hematuria please
indinavir
a/se: hyperglycemia, gi upset, lipodystrophy
protease inhibitors, the NAVIRs
what drug si contraindicated with protease inhibtitors and why
rifampin
CYP inducer so would decreased protease inhibitor concentration
please list the NRTIs
abacavir didanosine emtricitabine lamicudine stacudine tenofocir zidocudine (formerly azt)
how do NRTis work?
completely inhibit nucleotide binding to reverse transcriptase and terminate the DNA chian because they lack a 3’OH,
what NRTI is not a nucleoside
tenovofir - doesn’t need to be phosphorylated to be active
what is the NRTI for use in pregos?
zidovudine/formerly known as azt
what is the NRTI used for general prophylaxis
zidovudine
a/se of all NRTIs pelase
bone marrow suppression
peripheral neurpahty
a/se unique to the NRTI nucleosides
lactic acidosis
what NRTI casues anaemia?
zidovudine
what NRTI causes pancreatitits
didanosine
how can you prevent some of the side effects of NRTIs
bone marrow suppression = give EPO and G-CSF
a/se of bone marrow suppression, peripheral neuropathy
NRTIs
a/se of lactic acidosis
metformin ;) nucleoside NRTI (all but tenovofir)
a/se of pancreatitis
didanosine
a/se of anaemia
ziduvodine
please list the NNRTis
delavirdine
efavirenz
nevirapine
MOA of the NNRTIs please
bind to reverse transcriptase at site different from NRTIs
do nto require phosphyrlation to be active or to compete with nucletides
list the drugs that DO not require to be Pi in HIV treatment
tenovofir, an NRTI
all the NNRTIs (delavirdine, efacirnez, nevirapine)
what drugs for HIV are contraindicated in pregos
NNRTIs: delavirdine, efavirnez
what are the ase of the NNRTis
rash and hepatotoxicity (indinavir, a protease inhibitor cause hematuria and nephrotoxicity)
a/se of efavirenz
vivid dreams and CNS symptoms
a/se rash and hepatotoxicity
NNRTIsL delavirdine, efavirenz, nevirapine
a/se of vivid dreams and CNS symptoms
efavirenz
list the integrase inhibitors
raltegravir
MOA fo raltegravir
inhibits HIV genemoe integration into host cell chrom by reversibly inhibiting HIV integrase
a/se of ratelgrivir
increases creatine kinase
a/se of increased creatine kinase
raltegrivir, the integrase inhibitor
list the fusion inhibitors pelase
enfuvirtide
maroviroc
moa of enfuvirtide
a fusion inhibitor
binds gp41 inhibiting viral entry
moa of maraviroc
binds CCR5 of t cells and monocytes
inhibits interaction with HIV’s gp21
a/se of enfurvirtide
skin reaction at injection site
ts for chronic hepatitis B
IFNa
tx for chronic hepatitis C
IFNa
ribavirin
simeprevir
sofosbuvir
tx for Kaposi sarcoma
IFNa
tx for hairy cell leukemia
IFNa
tx for condyloma acuminatum
IFNa
tx for renal cell carcinoma
IFNa
tx for malignant melaonma
IFNa
tx for multiple sclerosis
IFNb
tx for chronic granulomatous disease
IFNg
toxos of interferones please
neutropenia
myopathy
a/se of neutropenia and myopathy
interferons
what are the drugs used for hep C tx?
ribavirin
simeprevir
sofosbuvir
moa of ribavirin please
inhibits synth of guanine nucleotides by competitively inhibiting INOSINE MONOPI DEHYDROGENASE
what is ribavirin used for
hep C and RSC
what is DOC in children for RSV
palivizumba (ribavirin)
what is toxicity of ribavirin
hemolytic aneamia
severe teratogen
what is the moa of simeprevir
HCV protease inhibitor
prevents viral replication
what are uses of simpervir
HCV with ribavirin and pegIFNa
what are toxos of simeprevir
rash and photosensitivity
anti virals that can give a rash
simeprevir and NNRTis
what is the moa of sofosbuvir
inhibits HCV RNA dependent RNA polymerase
chain terminator
what is cxl use of sofosbuvir
chronic HSV in combo with ribavirin and or not with peginterdreon
what are the toxocs of sofosbuvir
fatigue, headache nausea
toxos of hemolytic anaemia, and teratogen
ribavirin
toxos of rahs and photosensitivity
simeprevir
toxos fo fatigue, headache, nausea
sofosbuvir
what anti virals can cause nephrotoxicity
acyclovir/famciclovir, valacyclovir
canciclovir
foscarnetcidofovir
NRTIs
what anti virals affect blood cells
galnciclovir: leuko/thromboy/neutron penias
NRTIs: bone marrow suppression
ribavirin: hemolytic anaemia
what do ganciclovir, NRTIs and ribavirin all have in common
cause side effects involving blood cells.
what type of infection control techniques for enveloped viruses
alcohols and chlorhexidine - denaturs proteins and disrupts cell membranes
what infection control techniques for spores
hydrogen peroxis - free radial oxidation
what am I? delavirdine
NNRTi
what am I? stavudine
NRTI
what am I? enfuvirtide
fusion inhibitor
what am I? efavirenz
NNRTI
what am I? sofosbuvir
hep C treatment
what am I? nevirapine
NNRTI
what infection control techniaues MIGHT be sporicidal
autoclave and iodine/iodophores
a/se in pregos: kernicterus
sulfonamides
a/se in pregos: ototoxicity
aminoglycosides
a/se in pregos: cartilage damage
fluoroquinolones
a/se in pregos: embryotocix
chlarithromycin
a/se in pregos: discolored teeth, inhibition of bone growth
tetracyclines
a/se in pregos: teratogenic x two
ribavirin
griseofulvin
a/se in pregos: gray baby syndrome
chloramphenicol
a/se in pregos: sulfonamides
kernicterus
a/se in pregos: aminoglycosides
ototoxicity
a/se in pregos: ribavirin
teratogen
a/se in pregos: griseofulvin
a/se in pregos:
a/se in pregos: tetracyclines
discoloured teeth and bone growth inhibition
a/se in pregos: fluroquinolones
cartilage damage
a/se in pregos: clarithromycin
embryotoxic
a/se in pregos: chloramphenicol
gray baby syndrome
