Anti-Virals Flashcards
CMV is a ___ type of virus
ds DNA
drugs for CMV
ganciclovir, valganciclovir
CMV drug target
block viral DNA synthesis
ganciclovir moa (2 effects)
mimics guanosine, converted to the active triphosphate form by viral and cellular enzymes
competes w/ GTP for polymerase binding and incorporates into DNA causing termination
resistance to ganciclovir
mutations in CMV kinase or CMV DNA pol
ganciclovir toxicity
myelosuppression, potential teratogen
PK issues w/ ganciclovir
low oral bioavailability
corrected w/ valganciclovir, the prodrug form
targets for flu drugs
coat proteins- M2 channel and neuraminidase
amantadine and rimantidine moa
inhibit viral uncoating at M2 proton pump (acidifies interior and helps w/ uncoating)
oseltamivir and zanamivir moa
inhibit virion release by inhibiting neuraminidase cleavage of sialic acid-hemagglutinin complex
inhaled zanamivir toxicity
broncospasm- avoid w/ asthma or COPD
ribivarin moa
inhibits viral RNA synthesis, it is a guanosine analogue
3 effects: inhibits GTP synthesis, RNA replication, and incorporates to make a defective genome
ribivarin use
for RSV- never uses DNA
difficult to administer, rarely used
PK issues for ribivarin
high Vd b/c it concentrates in RBCs and has slow release
clearance is reduced w/ renal deficiency, leads to more buildiup in RBCs
ribivarin toxicity
hemolytic anemia- dose dependent and reversible
category X teratogen- never use for pregnant woman, birth control for 7 months after using