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🄼💊Chemotherapy/AntiViral/Botanicals > Anti-Virals > Flashcards

Anti-Virals Flashcards

1
Q

[Abreva Docosanol] MOA

A

[Long chain alcohol] that disturbs HSV cell membrane –> DEC HSV entry

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2
Q

Most of theHerpes Family Drugs are _______. What makes Valacyclovir/ValGangcyclovir unique?

A

Anti-Herpes = Nucleoside Analogs

Val = added Valine (Proprodrug) –> INC PO bioavailability

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3
Q

Describe how the Herpes family may become drug resistant. What does this mean for outcome?

A

[Viral Thymidine Kinase] adds the first phosphate to Acyclovir –> [Acyclovir monophosphate] (human enzymes add the other 2).

Herpes virus with mutated TK –> Drug Resistance.

but…

Mutated TK Herpes –> viral weakness and so aren’t as common

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4
Q

Acyclovir MOA

A

[Acyclovir TriPhosphate] is a Guanosine analog that incorporates into replicating viral DNA –> Halts synthesis

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5
Q

Acyclovir Indication (2)

A

HSV

Zoster (shingles)

(IV for encephalitits)

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6
Q

Acyclovir SE (3)

A
  1. [Renal Damage w/rapid infusion (interstitial nephritis vs. crystalline nephropathy] (check pt hydration status)
  2. HA
  3. GI sx
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7
Q

How many DDI does Acyclovir have?

A

4 serious interactions with abx

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8
Q

Ganciclovir MOA

A

Herpes Guanosine analog, first phosphorylated by [Herpes UL97 kinase]–> Chain Termination

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9
Q

Ganciclovir Indication (5)

A
  1. [CMV Pizza Pie Retinitis - PO]
  2. [CMV Post Transplant Px - IV]
  3. [HHV6 and 7 Roseola]
  4. [HHV8 Kaposi Sarcoma]
  5. EBV
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10
Q

Ganciclovir SE (4)

A

u throw Bones in the Grass, u get a R**ash. U ThrowUp in the Grass and then u Pass

  1. [Bone Marrow Suppression]
  2. Rash
  3. NVD
  4. Neurotoxicity (rare)
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11
Q

How many DDI does Ganciclovir have?

A

4 serious interactions with abx

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12
Q

Foscarnet MOA

A

Fos = phos

[pyrophosphate binding site] blocker –> Directly inhibits [Viral DNA polymerase]

NOT FIRST LINE TX

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13
Q

Foscarnet Indication (5)

A

“Gonna play CHER Voice in my Fas Car”

  1. [HSV-Resistant]
  2. [CMV Pizza pie Retinitis - IV]
  3. Varicella Zoster
  4. EBV
  5. [HHV6 & 7 Roseola]
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14
Q

Foscarnet SE (4)

A

You’ll be saying AMEN, taking Fos For 2 long!

  1. NEPHROTOXIC (Glomeruli Crystals)
  2. Electrolyte Disturbances (DEC Ca+ and Mg+)
  3. Myelosuppression
  4. Anemia
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15
Q

How many DDI does Foscarnet have?

A

None

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16
Q

Foscarnet Pharmacokinetics

A

[2-4 hour short half life] but deposits in bone

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17
Q

PriTelivir MOA

A

PriTelivir (Pretty boy on sketchy) =

Inhibits HSV Helicase-Primase

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18
Q

PriTelivir Indication

A

HSV

Replaces Foscarnet as adjunct to Acyclovir-therapies

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19
Q

Direct Acting Antivirals are used to CURE ___.

NS3 describes which HCV enzyme

A

Direct Acting Antivirals are used to CURE Hep C

NS3 = Protease

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20
Q

Direct Acting Antivirals are used to CURE ___.

NS5-A describes which HCV enzyme

A

Direct Acting Antivirals are used to CURE Hep C

NS5-A = Phosphoprotein

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21
Q

Direct Acting Antivirals are used to CURE ___.

NS5-B describes which HCV enzyme

A

Direct Acting Antivirals are used to CURE Hep C

NS5-B = [RNA-dependent RNA Polymerase]

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22
Q

Which inhibiting components make up the [Multidrug DAA],

Viekira? (4)

A

PORD

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23
Q

Which inhibiting components make up the [Multidrug DAA],

Harvoni? (2)

A

Ledipasvir (inhibits NS5-A)

SOfosbuvir (inhibits NS5-B)

24
Q

Which inhibiting components make up the [Multidrug DAA] that only inhibits NS3? (3)

A

Sim, Tela & Boce

25
Q

What is the [Multidrug DAA] Dose Regimen for Curing HCV.

Which HCV genotype does this cure?

A

[1 PO QD x 12-24 weeks +/- Ribavirin and IFN-alpha] –> Cures HCV Genotype 1 only

26
Q

[Multidrug DAA] SE (3)

A

Minor Fatigue

Constitutional

Insomnia

27
Q

How many DDI does [Multidrug DAA] have?

A

[P-gp inducers] DEC [Multidrug DAA] effect

28
Q

[Multidrug DAA] Pharmacokinetics

A

[1-2 Day half life] with renal elimination

29
Q

Ribavirin MOA (3)

A
  • Nucleoside Analog that…*
    1. Depletes GTP pools
    2. [Directly Blocks Viral RNA polymerase –> viral replication errors]
    3. Triggers CD8 activation
30
Q

Ribavirin Indication (2)

A
  1. HCV
  2. RSV (Non-pregnant Adults)
31
Q

Ribavirin SE (2)

A
  1. [Severe Hemolytic Anemia]
  2. Teratogenic
32
Q

How many DDI does Ribavirin have?

A

Toxic when co-administered with [HIV RT inhibitors]

33
Q

Ribavirin is typically only used in conjunction with _____

A

Ribavirin is typically only used in conjunction with IFN-alpha

IFN-alpha is at least 50% effective when with Ribavirin

34
Q

IFN-alpha MOA

A

Stimulates [DEC Protein Synthesis of neighboring cells] (host antiviral immunity)

IFN-alpha = Pegylated Interferon-alpha

35
Q

IFN-alpha Indication (2)

A

[Hep C: Genotypes 2 & 3] (but can suppress all)

36
Q

IFN-alpha SE (3)

A
  • Flu-like sx
  • Depression
  • Cirrhosis exacerbation
37
Q

How many DDI does IFN-alpha have?

A

> 200! and > 20 are major! smh

38
Q

IFN-alpha Pharmacokinetics

A

PEG INC [IFN-alpha] lifetime x 10 –> 3 Days long

39
Q

Risk Factors for Progression of Hep B (3)

A
  1. [Elevated HBV DNA + INC serum ALT]
  2. [Male vs. Older vs. HCC fam hx]
  3. Coinfection with [Hep C, D or HIV]
40
Q

When is it indicated to treat a Hep B positive pt? (4)

A
  1. [Liver Failure + chronic Hep B]
  2. [Cirrhosis + chronic Hep B]
  3. [HBV DNA >105] + [INC ALT >3 mo.]
  4. [HBV DNA >104] + [INC ALT >3 mo.] + [E-antigen]
41
Q

Entecavir MOA (3)

A

Guanosine analog that Inhibits HBV

DNA priming / RT / DNA pol

42
Q

Entecavir Indication

A

Hep B (including Lamuvidine resistant ones)

43
Q

Entecavir SE (2)

A

Lactic Acidosis

Rebound Hepatitis

44
Q

Describe any DDI Entecavir has?

A

“GA Tec doesn’t have Heart…so dont’ give em HAART!”

Can’t be given with HAART

45
Q

Entecavir Pharmacokinetics

A

LONG HALF LIFE and excreted via glomeruli

46
Q

Tenofovir MOA for Hep B

A

Prodrug hydrolyzes to Adenosine analog –> phosphorylated to Ten-PPP —> Inhibits HBV DNA pol (but works as a NRTI in HIV)

47
Q

Tenofovir Indication (2)

48
Q

Tenofovir SE (3)

A

Hep B Flare

Nephrotoxic

[Lactic Acidosis Hepatic Steatosis Syndrome]

49
Q

Describe any DDI Tenofovir has?

A

Many DDI

Watch for Nephrotoxicity and [Lactic Acidosis Hepatic Steatosis Syndrome]

50
Q

[Amantadine & Rimantadine] MOA

A

Prevents intracell Viral Uncoacting by plugging [M2 ion channel]–> Viral RNAs are not released into cell

OBSOLETE DRUGS

51
Q

[Amantadine & Rimantadine] Indication

A

Influenza A (70% of flu)

OBSOLETE DRUGS

52
Q

[Oseltamivir & Zanamivir] MOA

A

Neuraminidase inhibitors –> prevents [sialic acid anchor] from being cleaved –> prevents release

53
Q

[Oseltami​vir & Zanamivir] Indication (2)

A

Influenza A and B

54
Q

[Oseltami​vir & Zanamivir] SE (3)

A
  1. GI Sx (including NV)
  2. Insomnia
  3. Vertigo
55
Q

Route of Admin for [Oseltami​vir & Zanamivir]. Dose Regimen

A

[(Oseltamivir = PO) / (Zanamivir = Aerosol inhalant)]

Postexposure Px: Start within 2 days of exposure and continue QD x 10 days vs. [6 weeks during outbreak]. This shortens Dz by 1-2 days

56
Q

[Oseltami​vir & Zanamivir] Pharmacokinetics

A

“Tami tolerates it well. She reached her Climax in 1 hour!”

Well tolerated; Reaches Peak Conc. in 1 hour

🄼💊Chemotherapy/AntiViral/Botanicals (4 decks)

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