Anti-virals Flashcards
viruses
intracellular
no cell wall or cell membrane
consist of nucleic acids surrounded by protein caspid
require host to replicate
viral process
- viral entry into host cell
- attachment
- entry of virus into host ell membrane
- uncoding of viral RNA
- synthesis of regulatory proteins
- assembly of viral proteins
- release of viral proteins outside cell
what viruses do we tx available for?
influenza respiratory synctial virus (RSV) herpesviruses CMV HIV Viral Hep B and C
Influenza pathogenesis
replication in resp epithelium, viral shedding in resp secretions, trasmission via resp droplets
Antiviral influenza
adamantanes - highly resistant
neuraminidase inhibitors - oseltamivir, zanamivir
oseltamivir and zanamivir
neuraminidase inhibitors
MOA: block active site of neuraminidase, reduce viral particles released, decreased shedding
drugs for herpes virus
acyclovir
famiclovir
valacyclvir - converted to acyclovir after oral
better bioavailability
MOA for herpes drugs
acyclovir is guanosine anaolog is incorporated into viurs DNA and inhibits further synthesis
Chronic Hep B tx
immunomodulatory therapy - interferon
antiviral agents - lamivudine, tenofivir (supress virus)
Tenofovir
nucleotide analog inhibits hep B reverse transcriptase
perfered 1st line
viral vaccinations
varicella - live attenuated MMR - live attenuated zoster - live attenuated polio - killed rabies - killed hep A - killed influenza - killed or live hep B - recombinent protein HPV - recombinent protein
never give live vaccine when
CD4 count is <200
Protease inhibitor side effects
GI hyperlipidemia and hypertriglyceridemia insulin resistance CYP interactions lipatrophy
nucleoside reverse transcriptase inhibitors class wide issues
renal dosing
lactic acidosis and hepatic steatosis
peripheral neuropathy
lipatrophy
most common blood born disease in US
Hep C
