Anti-Virals Flashcards
What are the four targets of HIV drugs?
- entry
- RT
- integrase
- protease
What are the four NRTIs? What is the their MOA?
LATE
- lamivudine
- abacavir
- tenofovir
- emtricitabine
-analog posers - terminate Viral DNA
Which NRTIs is known to cause nephrotoxicity?
tenofovir
As a class, the NRTIs are known to cause what side effect?
lactic acidosis
What are the four NNRTIs? MOA?
NEER
- Nevirapine
- efavirenz
- etravirine
- rilpirine
-directly inhibit RT
What is the main s/e of NNRTIs?
rash
Which NNRTI can’t be used in pregancy? why?
efavirenz - teratogenic
Nevirapine and Etravirine are known to cause s/e in what organ?
liver
Rilpivirine has what s/e?
QT prolongation
What are the protease inhibitors? (5)
“Navir”
- ritonavir
- fosamprenavir
- lopinavir
- atazanavir
- darunavir
Explain why Ritonavir has a “good” drug s/e
it boosts the concentrations of other drugs
inhibits P4503A4
reduces frequency of dosing and improves adherence
What are the main s/e of protease inhibitors?
metabolic:
dyslipidemia, hyperglycemia, lipodystrophy (cushings)
What is the only HIV drug that is injectable? what does it do? when is it used?
enfuviritide
- entry inhibitor
- used when a patient has built up a lot of resistance
Which drug inhibits CCR5?
Maraviroc
Which drugs are integrase inhibitors?
RED- “ TEGravir”
- raltegravir
- elvitegravir
- dolutegravir
What are the requirements of HAART therapy?
patient must be willing and able to commit
regimen must include 3 different agents from at least 2 classes
What is considered an undetectable viral load?
<20 copies/mL within 24-48 wks of therapy
What happens first: drop in viral load, or inc in CD4 cells?
drop in viral load
How is a person determined to be “cured of Hep C?
sustained viral response - no detectable viral load 12 weeks after termination of therapy
What is the MOA of interferon?
establishes a general anti-viral state of cells
What are the s/e of interferon?
flu like symptoms, cytopenias, depression, fatigue
What is ribavirin?
old Hep C drug used with interferon
-nucleoside analog
What are the s/e of ribavirin?
hemolytic anemia and teratogenic
Which drug is a NS5B polym inhibitor?
Sofosbuvir
Which drug is a NS5A polym inhibitor?
Ledispasvir
Which drugs are a NS3/4A protease inhibitor?
“Previr” - prevent maturation of virus
- simeprevir
- telaprevir
- broceprevir
How do guanosine nucleoside antivirals get activated?
phosphorylated in infected cells via viral thymidine kinase
What drug is the drug of choice for HSV infections?
Acyclovir
What are the s/e of acyclovir?
GI, CNS, renal dysfunction
Which infections is penciclovir good for?
HSV1 and 2 and varicella zoster
same as acyclovir
What is the drug of choice for CMV?
ganciclovir
What is the main s/e of ganciclovir?
myelosuppression
What are the guanosine nucleoside antivirals notorious for?
poor bioavailability
Which guanosine nucleoside antiviral is only available IV? moa?
foscarnet
-directly inhibits DNA polym or HIV RT
What is the negative of using foscarnet?
significant toxicity - renal, electrolyte, CNS, myelosupppresion
What are the two neuraminidase inhibitors? what are they used for?
- oseltamivir
- zanamivir
-influenza A and B
When do the neuraminidase inhibitors need to be given?
within 48 hours of symptoms
What are the s/e of the neuraminidase inhibitors?
GI, neuropsych issues
