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Pharmocology - step > anti-virals > Flashcards

anti-virals Flashcards

1
Q

moa of oseltamivir

A

inhibits influenze neuraminidase - decreases release of progeny viruses

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2
Q

moa of zanamivir

A

inhibits influenza neuraminidase - decreases release of progeny viruses

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3
Q

treatment of influenza A and B

A

oseltamivir
zanamivir
MIVIRs

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4
Q

prevention of influenza A and B

A

oseltamivir
zanamivir
MIVIRs

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5
Q

MOA of acyclovir/famciclovir, valacyclovir

A

guanosine analougs
monoPi by HSV/VZV thymidine kinase and not uninfected cells
triphosphate by host enzymes
inhibits viral DNA polymerase by chain termination

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6
Q

treatment of HSV and VZV

A

acyclovir, famciclovir, valacyclovir

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7
Q

what virsus foes acyclovir, famiciclovir and valacyclovir work against?

A

HSV, VZV, weak against EBV

NO CMV

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8
Q

treatment of HSV induced mucocutanoeus and genital lesiosn

A

acyclovir
famiciclovir
valacyclovir

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9
Q

treatment of HSV encephalitis

A

acyclovir
famiciclovir
valacyclovir

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10
Q

use of acyclovir in immunosuppressed indvls

A

prhophylaxis

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11
Q

doc at herpes zoster

A

famiciclovir

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12
Q

toxo of acyclovir

A

obstructive crystalline nephropathy

acute renal failure

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13
Q

how do prevent toxo of acyclovir

A

hydration to prevent obstructive crystalline nephropathy/acute renal failure

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14
Q

how do HSV and VZV resists acyclovir

A

muta viral thymidine kinase

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15
Q

moa fo ganciclovir

A

5’monophosphate formed by a CMV viral kinase
guanosine analog
triphosphate formed by cellular kinases
inhibits viral DNA polymerase by chain termination

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16
Q

doc of CMV, especially in immunocmopromised

A

ganciclovir

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17
Q

toxos of ganciclovir

A

leukopenia
neutropenia
thrombocytopenia
renal toxicity

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18
Q

which is more toxic to host cells, acyclovir of ganciclovir

A

ganvivclovir - leuko/neutron/thrombocytopenia

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19
Q

moa of resistane of ganciclovir

A

mutated viral kinase

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20
Q

moa of foscarnet

A

viral DNA/RNA polymerase inhibitor and HIV reverse transcriptase inhibitor
binds to pyroFOSphaste binding site
NO ACTIVATION BY KINASE REQUIRED

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21
Q

what is foscarnet used for

A

CMV retinitins when ganciclovr doesn’t work

acyclovir resistant HSV

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22
Q

toxo of foscarnet please

A

nephrotoxicity
electrolyte abnormalities: hypo/hyperCa AND hypo/hyperPO4 and hypoK and hypoMg
electorylte abnormalities can lead to seizures

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23
Q

MOA resistance foscarnet

A

mutated DNA plymerase

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24
Q

MOA cidofovir

A

preferentially inhibits viral DNA polymerase

DOES NTO REQUIRE PHOS BY KINASE

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25
Q

which two drugs for CMV do not require pi by kinase

A

foscarnet and cidofovir

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26
Q

what is the use of cidofovir

A

CMV retinitis in immunocompromised patients

acyclovir restiant HSV

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27
Q

toxo of cidofover

A

nephrotoxocity

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28
Q

how to prevent nephrotoxicity of cidofovir

A

give with probenecid and IV saline to decrease nephrotoxicity of cidofovir

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29
Q

how to treat HIV

A

three drug regimen to prevent resistance

2 x NRTIs and 1 x of a) NNRTI, b) integrase inhibitor or c( protease inhibitors

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30
Q

list the protease inhibitors

A 
NAVIRS
atazanavir
darunavir
fosamprenavir
indinavir
lopinavir
ritonavir
saduinavir
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31
Q

moa of preotease inhibitors

A

assumble of virions requires HIV-1 protease (pol gene) to cleave polypeptide of HIV mRNA into functional parts. so prevents maturation of new viruses

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32
Q

what makes ritonavir special?

A

inhibits P450 to boost other drug concentrations

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33
Q

common side effects of all protease inhibitors

A

hyperglycemia
lipodystrophy
nausea and diarrhoea

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34
Q

side effects of indinavir pelase

A

nephropathy

hematuria

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35
Q

proteas inhibitor that can cause nephropathy and hematuria please

A

indinavir

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36
Q

a/se: hyperglycemia, gi upset, lipodystrophy

A

protease inhibitors, the NAVIRs

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37
Q

what drug si contraindicated with protease inhibtitors and why

A

rifampin

CYP inducer so would decreased protease inhibitor concentration

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38
Q

please list the NRTIs

A 
abacavir
didanosine
emtricitabine
lamicudine
stacudine
tenofocir
zidocudine (formerly azt)
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39
Q

how do NRTis work?

A

completely inhibit nucleotide binding to reverse transcriptase and terminate the DNA chian because they lack a 3’OH,

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40
Q

what NRTI is not a nucleoside

A

tenovofir - doesn’t need to be phosphorylated to be active

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41
Q

what is the NRTI for use in pregos?

A

zidovudine/formerly known as azt

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42
Q

what is the NRTI used for general prophylaxis

A

zidovudine

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43
Q

a/se of all NRTIs pelase

A

bone marrow suppression

peripheral neurpahty

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44
Q

a/se unique to the NRTI nucleosides

A

lactic acidosis

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45
Q

what NRTI casues anaemia?

A

zidovudine

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46
Q

what NRTI causes pancreatitits

A

didanosine

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47
Q

how can you prevent some of the side effects of NRTIs

A

bone marrow suppression = give EPO and G-CSF

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48
Q

a/se of bone marrow suppression, peripheral neuropathy

A

NRTIs

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49
Q

a/se of lactic acidosis

A 
metformin ;)
nucleoside NRTI (all but tenovofir)
50
Q

a/se of pancreatitis

A

didanosine

51
Q

a/se of anaemia

A

ziduvodine

52
Q

please list the NNRTis

A

delavirdine
efavirenz
nevirapine

53
Q

MOA of the NNRTIs please

A

bind to reverse transcriptase at site different from NRTIs

do nto require phosphyrlation to be active or to compete with nucletides

54
Q

list the drugs that DO not require to be Pi in HIV treatment

A

tenovofir, an NRTI

all the NNRTIs (delavirdine, efacirnez, nevirapine)

55
Q

what drugs for HIV are contraindicated in pregos

A

NNRTIs: delavirdine, efavirnez

56
Q

what are the ase of the NNRTis

A

rash and hepatotoxicity (indinavir, a protease inhibitor cause hematuria and nephrotoxicity)

57
Q

a/se of efavirenz

A

vivid dreams and CNS symptoms

58
Q

a/se rash and hepatotoxicity

A

NNRTIsL delavirdine, efavirenz, nevirapine

59
Q

a/se of vivid dreams and CNS symptoms

A

efavirenz

60
Q

list the integrase inhibitors

A

raltegravir

61
Q

MOA fo raltegravir

A

inhibits HIV genemoe integration into host cell chrom by reversibly inhibiting HIV integrase

62
Q

a/se of ratelgrivir

A

increases creatine kinase

63
Q

a/se of increased creatine kinase

A

raltegrivir, the integrase inhibitor

64
Q

list the fusion inhibitors pelase

A

enfuvirtide

maroviroc

65
Q

moa of enfuvirtide

A

a fusion inhibitor

binds gp41 inhibiting viral entry

66
Q

moa of maraviroc

A

binds CCR5 of t cells and monocytes

inhibits interaction with HIV’s gp21

67
Q

a/se of enfurvirtide

A

skin reaction at injection site

68
Q

ts for chronic hepatitis B

A

IFNa

69
Q

tx for chronic hepatitis C

A

IFNa
ribavirin
simeprevir
sofosbuvir

70
Q

tx for Kaposi sarcoma

A

IFNa

71
Q

tx for hairy cell leukemia

A

IFNa

72
Q

tx for condyloma acuminatum

A

IFNa

73
Q

tx for renal cell carcinoma

A

IFNa

74
Q

tx for malignant melaonma

A

IFNa

75
Q

tx for multiple sclerosis

A

IFNb

76
Q

tx for chronic granulomatous disease

A

IFNg

77
Q

toxos of interferones please

A

neutropenia

myopathy

78
Q

a/se of neutropenia and myopathy

A

interferons

79
Q

what are the drugs used for hep C tx?

A

ribavirin
simeprevir
sofosbuvir

80
Q

moa of ribavirin please

A

inhibits synth of guanine nucleotides by competitively inhibiting INOSINE MONOPI DEHYDROGENASE

81
Q

what is ribavirin used for

A

hep C and RSC

82
Q

what is DOC in children for RSV

A

palivizumba (ribavirin)

83
Q

what is toxicity of ribavirin

A

hemolytic aneamia

severe teratogen

84
Q

what is the moa of simeprevir

A

HCV protease inhibitor

prevents viral replication

85
Q

what are uses of simpervir

A

HCV with ribavirin and pegIFNa

86
Q

what are toxos of simeprevir

A

rash and photosensitivity

87
Q

anti virals that can give a rash

A

simeprevir and NNRTis

88
Q

what is the moa of sofosbuvir

A

inhibits HCV RNA dependent RNA polymerase

chain terminator

89
Q

what is cxl use of sofosbuvir

A

chronic HSV in combo with ribavirin and or not with peginterdreon

90
Q

what are the toxocs of sofosbuvir

A

fatigue, headache nausea

91
Q

toxos of hemolytic anaemia, and teratogen

A

ribavirin

92
Q

toxos of rahs and photosensitivity

A

simeprevir

93
Q

toxos fo fatigue, headache, nausea

A

sofosbuvir

94
Q

what anti virals can cause nephrotoxicity

A

acyclovir/famciclovir, valacyclovir
canciclovir
foscarnetcidofovir
NRTIs

95
Q

what anti virals affect blood cells

A

galnciclovir: leuko/thromboy/neutron penias
NRTIs: bone marrow suppression
ribavirin: hemolytic anaemia

96
Q

what do ganciclovir, NRTIs and ribavirin all have in common

A

cause side effects involving blood cells.

97
Q

what type of infection control techniques for enveloped viruses

A

alcohols and chlorhexidine - denaturs proteins and disrupts cell membranes

98
Q

what infection control techniques for spores

A

hydrogen peroxis - free radial oxidation

99
Q

what am I? delavirdine

A

NNRTi

100
Q

what am I? stavudine

A

NRTI

101
Q

what am I? enfuvirtide

A

fusion inhibitor

102
Q

what am I? efavirenz

A

NNRTI

103
Q

what am I? sofosbuvir

A

hep C treatment

104
Q

what am I? nevirapine

A

NNRTI

105
Q

what infection control techniaues MIGHT be sporicidal

A

autoclave and iodine/iodophores

106
Q

a/se in pregos: kernicterus

A

sulfonamides

107
Q

a/se in pregos: ototoxicity

A

aminoglycosides

108
Q

a/se in pregos: cartilage damage

A

fluoroquinolones

109
Q

a/se in pregos: embryotocix

A

chlarithromycin

110
Q

a/se in pregos: discolored teeth, inhibition of bone growth

A

tetracyclines

111
Q

a/se in pregos: teratogenic x two

A

ribavirin

griseofulvin

112
Q

a/se in pregos: gray baby syndrome

A

chloramphenicol

113
Q

a/se in pregos: sulfonamides

A

kernicterus

114
Q

a/se in pregos: aminoglycosides

A

ototoxicity

115
Q

a/se in pregos: ribavirin

A

teratogen

116
Q

a/se in pregos: griseofulvin

A

a/se in pregos:

117
Q

a/se in pregos: tetracyclines

A

discoloured teeth and bone growth inhibition

118
Q

a/se in pregos: fluroquinolones

A

cartilage damage

119
Q

a/se in pregos: clarithromycin

A

embryotoxic

120
Q

a/se in pregos: chloramphenicol

A

gray baby syndrome

Pharmocology - step (16 decks)

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