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CPT (Milpa) > Anti-virals > Flashcards

Anti-virals Flashcards

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1
Q

What drugs are used for influenza A & B?

A

Oseltamivir (tamiflu)

Zanamivir

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2
Q

Give examples of herpes infections

A

Cold sores
Encephalitis
Genital infections

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3
Q

Describe the treatment for herpes

A

Aciclovir
Cidofovir
Foscarnet

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4
Q

What drugs are given for cytomegalovirus?

A

Ganciclovir (prophylaxis in transplant patients)
Foscarnet
Cidofovir (resistant cases)

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5
Q

What drugs are used for HIV?

A

Combination of:

Nucleoside reverse transcriptase inhibitor (NRTI)

AND

Nuceloside reverse transcriptase inhibitor (NRTI)

AND (one of the following)

Non-nucleoside reverse transcriptase inhibitors (NNRTI)
Protease inhibitor
Integrate inhibitor
CCR5 (entry) inhibitor

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6
Q

Give an example of an NRTI

A

Lamivudine

Zidovudine

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7
Q

Give an example of an NNRTI

A

Nevirapine

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8
Q

What are the drugs used for hepatitis B?

A

Lamivudine
Interferon alpha
Adefovir

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9
Q

What drugs are used for hepatitis C

A

Sofosbuvir
Interferon alpha
Ribavirin (chronic) with interferon alpha

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10
Q

What is the mechanism of action of oseltamivir/zanamivir? (Treats influenza)

A

Neuroaminidase inhibitor

Blocks release of newly assembled influenza virons from host cell

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11
Q

What is the mechanism of action of aciclovir?

A

DNA base analogue
Activated by viral thymidine next kinase
Inhibits viral DNA synthesis

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12
Q

What is aciclovir used to treat?

A

Herpes, meningitis, encephalitis

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13
Q

What are the ADRs of aciclovir?

A 
Nephrotoxicity
CNS symptoms (1-4%) e.g. tremor, myoclonus, hallucinations, coma
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14
Q

At what stage in the infection is aciclovir effective?

A

In the acute phase when the patient is symptomatic

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15
Q

What is ganciclovir used to treat?

A

CMV (retinitis & prophylaxis for transplant pts)

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16
Q

What is the mechanism of action of ganciclovir?

A

Analogue of aciclovir
But activated by a different enzyme
Inhibits viral DNA synthesis

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17
Q

What are the ADRs of ganciclovir?

A

Myelosuppressive
Carcinogenic/teratogenic
CNS symptoms (5-15%)

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18
Q

What is cidofovir active against?

A

DS-DNA viruses:
Herpes
Pox
CMV

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19
Q

What is the mechanism of action of cidofovir?

A

Inhibits DNA polymerase

Therefore, inhibits chain elongation

20
Q

ADRs of cidofovir?

A

Nephrotoxic
Myelosuppressive
Neutropenia (24%)

21
Q

What is foscarnet used for?

A

CMV when ganciclovir-resistant

HSV when aciclovir-resistant

22
Q

ADRs of foscarnet?

A

Narrow therapeutic index
Mainly nephrotoxic
CNS effects

23
Q

Name 2 NRTIs

A

Lamivudine

Zidovudine

24
Q

What is the mechanism of action of NRTIs?

A

Inhibit DNA polymerase & reverse transcriptase

Prevent viral replication

25
Q

ADRs of NRTIs?

A

Hyperlactataemia
Lactic acidosis
Hepatomegaly
Steatosis (fat retention in cells)

26
Q

Name an NNRTI

A

Nevirapine

27
Q

What is the mechanism of action of NNRTIs?

A

Inhibits HIV reverse transcriptase

Used in combination with NRTIs (work at different sites)

28
Q

Give an example of a protease inhibitor?

A

Ritonavir

29
Q

What is a protease inhibitor used to treat?

A

HIV (in combo with 2 NRTIs)

30
Q

How do protease inhibitors work?

A

Block the cleavage of viral polyproteins by HIV protease enzyme
Prevent production of viral proteins (no mature virions)

31
Q

ADRs of protease inhibitors?

A

Induction/inhibition of CYP450 (drug interactions)
Chronic use - high cholesterol, TAG & glucose
- increased risk of MI and diabetes

32
Q

Give an example of an integrate inhibitor

A

Raltegravir

33
Q

What are integrate inhibitors used for?

A

HIV in combo with 2 NRTIs

34
Q

What is the mechanism of action of integrate inhibitors?

A

Prevent integration of HIV DNA provirus into the host cell genome

35
Q

What is sofosbuvir used for?

A

Hep C

36
Q

What’s if the mechanism of action of sofosbuvir?

A

Blocks action of HCV viral polymerase

Prevents production of a new virus

37
Q

What is interferon alpha used to treat?

A

Hep B and C

38
Q

What is the mechanism of action of interferon alpha?

A

Immunomodulatory effect

Stimulates proteins to enhance resistance to viral infection

39
Q

What are the ADRs of interferon alpha? And when are they seen?

A

First few hours to days - flu-like illness, fever, chills, headache, myalgia, NV

40
Q

What is ribavirin used for?

A

Chronic hep C in combo with interferon alpha

41
Q

Mechanism of action of ribavirin?

A

Guanosine analogue
Prevents viral mRNA capping
Prevents assembly of viral genome
Inhibits both RNA and DNA viruses

42
Q

ADRs of ribavirin?

A

Transient anaemia

Teratogenic

43
Q

What is adefovir used to treat?

A

Hep B

44
Q

What is the mechanism of action of adefovir?

A

False substrate and chain terminator of reverse transcriptase
Inhibits HBV DNA polymerase as well

45
Q

What are the ADRs of adefovir?

A

Low doses - well-tolerated

High doses - nephrotoxicity

CPT (Milpa) (20 decks)

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