Anti-virals

Question 1

Viral Illness

Answer 1

Dormant outside cells, Reproduce in cells–harder to kill
• Attach to cell, inject DNA/RNA, use cell resources to make more virus, cell releasing virus
• May have to affect host cell to treat
• May not eliminate entirely from body
**no internal metabolism

Question 2

Common Viruses

Answer 2

• Cocksackie virus (hand, foot, mouth disease)
• Parvovirus (5th disease)
• Adenovirus (respiratory)
• RSV-respiratory syncytial virus
• Herpes Simplex viruses(oral, genital herpes)
• Herpes Zoster or varicella zoster (chicken pox/shingles)

Question 3

Antivirals

Answer 3

• Relatively new—1980’s (HIV/AIDS)
• Difficult to be specific—no internal metabolism of their own
• More likely to affect host cell, too
• Side effects vary
• Some may be toxic to liver, kidney, nervous system

Question 4

Antiviral Uses

Answer 4

NOT cure but to limit

Flu, herpes, varicella

Question 5

Antiviral Drugs

Answer 5

• acyclovir (Zovirax)
• oseltamivir (Tamiflu)
• zanamivir (Relenza
• valacyclovir (Valtrex )
• amantadine (Symmetrel)

Question 6

HIV-AIDS

Answer 6

• HIV infects the T-helper cells(CD4+) and the macrophages of the immune system
• HIV is a retro virus-injects its RNA to make DNA–then force host cell to make virus (enzyme=RT)
• Transmission: person to person by sexual contact, blood contact, perinatal contact

Question 7

Signs and Symptoms of HIV-AIDS

Answer 7

• Initially-acute flu-like, then none (3-10YRS)
• Lymphadenopathy
• Fatigue
• Weakness
• HA
• Arthralgia
• Dementia
• Opportunistic disease

Question 8

AIDS diagnosis

Answer 8

• Stage of disease measured by T-cell count
• When CD4+ helper cell counts drops to less than 200–AIDS
• Eliza/Western Blot

Question 9

Opportunistic Disease

Answer 9

• Herpes
• Candida
• Cytomegalovirus (CMV)
• Pneumocystic carinii (PCP)
• Kaposi’s sarcoma (AIDS defining illness)

Question 10

Treatment of Virals

Answer 10

• No Cure, can only Improve Life and immune function
• Debate: when best time to treat with what drugs—they do have side effects
• Never treat with only one drug.

Question 11

1 NRTI - Nucleoside Reverse Transcriptase Inhibitors

Answer 11

fake amino acid in building DNA
• zidovudine - AZT Retrovir 
• didanosine - Videx
• stavudine (d4T) - Zerit
• lamivudine (3TC) - Epivir
• tenofovir (TDF) - Viread
• emtricitabine(FTC) Emtriva

Question 12

2 (NNRTR) Nonnucleoside Reverse Transcriptase Inhibitors

Answer 12

stop enzymes triggering DNA synthesis—changes enzyme shape
•Delavirdine (Rescriptor)
•Efavirenz (Sustiva)
•nevirapine (Virammune)
Some resistance developing to these drugs

Question 13

3 Protease Inhibitors

Answer 13

stops enzyme makes new virus infectious(can’t infect more T-cells)
• nelfinavir (Viracept)
• darunavir (Prezista)
• saquinavir (Fortovase)
• ritonavir (Norvir)
• ritonavir-boosted atazanavir (Revataz)
• indinavir (Crixivan)

Question 14

4 Fusion/Entry Inhibitor

Answer 14

prevents virus from fusing with cell:
•enfuvirtide, T-20 (Fuzeon)
•maraviroc (Selzentry)

**newer

Question 15

5 Integrase inhibitor

Answer 15

newer

inhibits an enzyme necessary to get DNA taken into host cell nucleus (tolerated well)
•raltegravir (Isentress)

Question 16

Monitoring of Disease

Answer 16

• Viral Load (plasma HIV RNA) - the lower, the better

* CD4 count - The higher , the better