antiv Flashcards
What is the brand name of
Acyclovir?
Zovirax
What drug class is Acyclovir in?
Viral DNA Polymerase Inhibitor
What are the indications for Acyclovir?
Genital herpes simplex, Herpes zoster,
Varicella, Cold sores
What is the mechanism of action of Acyclovir?
Acyclic nucleoside analogue of deoxyguanosine that is selectively phosphorylated by the virus-encoded thymidine kinase to its monophosphate form. Cellular enzymes then convert the
monophosphate to the active antiviral acyclovir triphosphate, which competitively inhibits viral DNA synthesis by inactivation of viral DNA polymerase and incorporation into and termination of viral DNA replication.
What are the major contraindications for
Acyclovir?
Hypersensitivity to acyclovir or valacyclovir
What are the black box warnings for Acyclovir?
None
What are the common adverse drug reactions for Acyclovir?
Malaise
What are the rare but serious adverse
drug reactions for Acyclovir?
Severe hypersensitivity, Renal failure,
TTP (Thrombotic thrombocytopenic purpura)
What are the key counseling points for
Acyclovir?
Complete full course of therapy. Ensure
adequate hydration. For HSV, initiate
treatment as soon as possible at first
sign of lesion. For VZV, treatment should
begin within 24 h of appearance of rash.
Symptoms should improve within 2-3d; if they worsen, seek follow-up with HCP. If using for prophylaxis or suppression of infection, this medication should reduce the number of breakouts
What is the brand name for Atazanavir?
Reyataz
What drug class is Atazanavir in?
Antiretroviral Agent, Protease Inhibitor
What are the indications for Atazanavir?
Treatment of HIV-1 infection in antiretroviral naive patients, patients with prior virologic failure, and antiretroviral naive or experienced pregnant patients
What is the mechanism of action of
Atazanavir?
Binds to the site of HIV-1 protease
activity and inhibits cleavage of viral
Gag-Pol polyprotein precursors into individual functional proteins required for infectious HIV. This results in the formation of immature, noninfectious viral particles.
What are the major contraindications for
Atazanavir?
Hypersensitivity or concurrent therapy
with interacting medications
What are the black box warnings for
Atazanavir?
None
What are the common adverse drug reactions for Atazanavir?
Rash, Hyperlipidemia, Elevated LFTs, Abdominal pain, Elevated bilirubin level, Cough, Fever
What are the rare but serious adverse drug reactions for Atazanavir?
Hypersensitivity, Renal failure, PR and QTc prolongation, Torsades de pointes, Cholelithiasis, Left bundle branch block
What are the key counseling points for Atazanavir?
Multiple, potentially serious drug interactions; do not take new medications without consulting HCP. Take with food. Do not open, chew, or crush capsule. Does not prevent transmission of HIV; practice safe sex. Do not skip doses. Report cardiac symptoms to physician. Do not take antacids within 2 h, H2 antagonists within 12 h, and avoid concurrent PPI use.
What is the brand name of Elbasvir/Grazoprevir?
Zepatier
What drug class is Elbasvir/Grazoprevir in?
NS3/4A Protease Inhibitor
(Anti-HCV)
What is the indication for Elbasvir/Grazoprevir?
Chronic hepatitis C (CHC)
infection
What is the mechanism of action of Elbasvir/Grazoprevir?
Elbasvir inhibits HCV NS5B RNA-dependent RNA polymerase, essential for viral replication. Grazoprevir inhibits NS3/4 protease, which cleaves the HCV polyprotein into mature forms and is required for replication.
What are the major contraindications for Elbasvir/Grazoprevir?
Hepatic
impairment, Strong CYP3A4/5 inducers
What are the black box warnings for Elbasvir/Grazoprevir?
HBV (Hepatitis
B Virus) reactivation
What are the common adverse drug reactions for Elbasvir/Grazoprevir?
Fatigue
What are the rare but serious adverse drug reactions for Elbasvir/Grazoprevir?
Severe hepatic disease, Anemia, Angioedema
What are the key counseling points for Elbasvir/Grazoprevir?
Do not remove drug from blister pack until ready to take. Take with or without food.
What is the brand name for Efavirenz?
Sustiva
What drug class is Efavirenz in?
Antiretroviral Agent, Reverse Transcriptase
Inhibitor
What are the indications for Efavirenz?
HIV-1 Infections
What is the mechanism of action of Efavirenz?
Binds to HIV reverse transcriptase, blocking the RNA-dependent and DNA-dependent DNA polymerase activities including HIV-1 replicaiton.
What are the black box warnings for Efavirenz?
None
What are the major contraindications for Efavirenz?
Hypersensitivity or concurrent use of bepridil, cisapride, elbasvir, grazoprevir, midazolam, pimozide, triazolam, St. John’s wort, or ergot alkaloids
What are the common adverse drug reactions for Efavirenz?
Anxiety, Dizziness, Insomnia, Headaches, Rash, Nausea, Vomiting, Diarrhea, Hyperlipidemia
What are the rare but serious adverse drug reactions for Efavirenz?
Psychosis, Seizures, Hepatic failure, Hypersensitivity, Pancreatitis, Suicidal ideation, Fat redistribution, Immune reconstitution syndrome
What are the key counseling points for Efavirenz?
Multiple, potentially serious drug interactions; do not take new medications, OTCs, or herbals without consulting HCP. Take on an empty stomach at bedtime. Do not open, chew, or crush capsule. Does not prevent transmission of HIV, practice safe sex. May cause drowsiness; avoid driving and concurrent CNS depressants.
What is the brand name for Emtricitabine/Tenofovir?
Truvada
What drug class is Emtricitabine/Tenofovir in?
Antiretroviral Agent, Reverse
Transcriptase Inhibitor
What are the indications for Emtricitabine/Tenofovir?
HIV-1 infections, Preexposure prophylaxis (PrEP) of HIV-1 infection
What is the mechanism of action of Emtricitabine/Tenofovir?
Emtricitabine is a cytidine analogue while Tenofovir is an analogue of adenosine 5’-monophosphate. Each drug interferes with HIV viral RNA-dependent DNA polymerase resulting in inhibition of viral replication.
What are the major contraindications for Emtricitabine/Tenofovir?
Do not use for preexposure prophylaxis in patients with unknown or HIV-1 positive status. Only for use in combination with other antiretrovirals.
What are the common adverse drug reactions for Emtricitabine/Tenofovir?
Hyperpigmentation, Rash, Hypophosphatemia, Nausea, Diarrhea, Abdominal pain, Weakness, Cough, Rhinitis, Dizziness, Headache, Insomnia, Fatigue, Decreased bone mineral density
What are the black box warnings for Emtricitabine/Tenofovir?
Hepatitis B exacerbation, Lactic acidosis, Drug resistance with preexposure prophylaxis
What are the rare but serious adverse drug reaction for Emtricitabine/Tenofovir?
Lactic acidosis, HBV exacerbations, Renal failure
What are the key counseling points for Emtricitabine/Tenofovir?
Take with or without food. Patients with history of bone fracture or osteopenia may consider calcium and vitamin D supplementation
What is the brand name for Entecavir?
Baraclude
What drug class is Entecavir in?
Antiretroviral Agent, Reverse Transcriptase
Inhibitor
What is the indication for Entecavir?
Chronic HBV Infection
What are the major contraindications for Entecavir?
None
What is the mechanism of action of Entecavir?
Intracellularly phosphorylated to guanosine triphosphate which competes with natural substances to effectively inhibit HBV polymerase; enzyme inhibition blocks reverse transcriptase activity thereby reducing viral DNA synthesis.
What are the black box warnings for Entecavir?
HIV resistance in chronic hepatitis B patients with unrecognized or untreated HIV infection; discontinuation of therapy may result in disease exacerbation; lactic acidosis
What are the common adverse drug reactions for Entecavir?
Edema, Elevated LFTs
What are the rare but serious adverse drug reactions for Entecavir?
Hypersensitivity, Renal failure, Hepatomegaly, Thrombocytopenia
What are the key counseling points for Entecavir?
Complete full course of
therapy; take on an empty stomach.
What is the brand name for Glecaprevir/Pibrentasvir?
Mavyret
What drug class is Glecaprevir/Pibrentasvir in?
NS3/4A Protease Inhibitor
(Anti-Hepatitis C Virus)
What is the indication for Glecaprevir/Pibrentasvir?
Chronic Hepatitis C Infection
What is the mechanism of action of Glecaprevir/Pibrentasvir?
Pibrentasvir
inhibits hepatitis C virus NS5B RNA-dependent RNA polymerase, essential for viral
replication. Glecaprevir inhibits NS3/4 protease, which cleaves the hepatitis C virus
polyprotein into mature forms and is required for replication.
What are the major contraindications for Glecaprevir/Pibrentasvir?
Hepatic impairment, Atazanavir, Rifampin
What are the black box warnings for Glecaprevir/Pibrentasvir?
HBV reactivation
What are the common adverse drug reactions for Glecaprevir/Pibrentasvir?
Fatigue, Nausea
What are the rare but serious adverse drug reactions for Glecaprevir/Pibrentasvir?
Severe hepatic disease, Angioedema
What are the key counseling points for Glecaprevir/Pibrentasvir?
Take with food
What is the brand name for Maraviroc?
Selzentry
What is the indication for Maraviroc?
CCR5-tropic HIV-1 Infection
What is the mechanism of action of Maraviroc?
Selectively and reversibly
binds to the chemokine (C-C motif receptor 5 [CCR5]) coreceptors located on human
CD4 cells. CCR5 antagonism prevents interaction between the human CCR5 coreceptor and the gp120 subunit of the viral envelope glycoprotein, thereby initiating
gp120 conformational change required for CCR5-tropic HIV-1 fusion with the CD4
cell and subsequent cell entry.
What are the major contraindications for Maraviroc?
Patients with CrCl <30 mL/min or ESRD (End Stage Renal Disease) who are taking potent CYP3A4/5 inhibitors or inducers
What are the black box warnings for Maraviroc?
Hepatotoxicity, Severe rash, Allergic reaction
What are the common adverse drug reactions for Maraviroc?
Fever, Upper respiratory infection, Rash, Cough, Vomiting
What are the rare but serious adverse drug reactions for Maraviroc?
Coronary artery disease, Angina, Jaundice, Hepatic failure, Seizures
What are the key counseling points for Maraviroc?
Take with or without food. Do not chew or crush tablet. Does not prevent transmission of HIV, practice safe sex, do not share needles, etc. May cause drowsiness; avoid driving and concurrent CNS depressants.
What is the brand name for Oseltamivir?
Tamiflu
What drug class is Oseltamivir in?
Neuraminidase Inhibitor, Antiviral
What is the indication for Oseltamivir?
Influenza
What is the mechanism of action of Oseltamivir?
Inhibitor of influenza virus neuraminidase, which prevents viral progeny detaching from the cellular envelope
What are the major contraindications for Oseltamivir?
Hypersensitivity
What are the black box warnings for Oseltamivir?
None
What are the common adverse drug reactions for Oseltamivir?
Nausea,
Vomiting, Headache
What are the rare but serious adverse drug reactions for Oseltamivir?
Arrhythmias, Anaphylaxis, Stevens-Johnson syndrome, Seizures, Delirium
What are the key counseling points for Oseltamivir?
Complete full course of
therapy. Symptoms should improve within 2-3d; if they worsen seek care. Take with food to minimize GI irritation. Take missed dose as soon as possible, if next dose is within 2 h, skip missed dose.
What is the brand name for Raltegravir?
Isentress
What drug class is Raltegravir in?
Antiretroviral Agent, Integrase Inhibitor
What is the mechanism of action of Raltegravir?
Inhibits the catalytic activity of HIV-1 integrase, thus preventing integration of the viral DNA into the host strand.
What is the indication for Raltegravir?
HIV-1 infection
What are the major contraindications for Raltegravir?
Hypersensitivity
What are the black box warnings for Raltegravir?
None
What are the common adverse drug reactions for Raltegravir?
Elevated LFTs
What are the rare but serious adverse drug reactions for Raltegravir?
Anemia, Cerebellar ataxia, Depression, Hepatitis, Hypersensitivity, Myopathy, Nephrolithiasis, Psychomotor hyperactivity (children), Renal failure, Rhabdomyolysis, Stevens-Johnson syndrome, Suicidal ideation/behavior, Thrombocytopenia, Toxic epidermal necorlysis
What are the key counseling points for Raltegravir?
Take with or without food. May chew or crush the chewable tablet. Does not prevent transmission of HIV; practice safe sex.
What is the brand name of Sofosbuvir?
Sovaldi
What drug class is Sofosbuvir in?
Polymerase Inhibitor
What is the indication for Sofosbuvir?
Chronic Hepatits C (CHC) Infection
What is the mechanism of action of Sofosbuvir?
A direct-acting antiviral agent against the hepatitis C virus. It inhibits HCV NS5B RNA-dependent RNA polymerase, essential for viral replication, and acts as a chain terminator.
What are the major contraindications for Sofosbuvir?
Because of ribavirin risk, do not use in pregnant women, or men whose female partners are pregnant
What are the black box warnings for Sofosbuvir?
HBV reactivation
What are the common adverse drug reactions for Sofosbuvir?
Fatigue, Headache, Insomnia, Chills, Pruritus, Rash, Nausea, Anemia
What are the rare but serious adverse drug reactions for Sofosbuvir?
Pancytopenia, Depression, Suicidality
What are the key counseling points for Sofosbuvir?
Pregnancy warnings (due to ribavirin risk) for female patients and female partners of male patients.
What is the brand name for Valacyclovir?
Valtrex
What drug class is Valacyclovir in?
Viral DNA Polymerase Inhibitor
What are the indications for Valacyclovir?
Genital herpes simplex, Herpes
zoster, Varicella, Cold sores
What is the mechanism of action of Valacyclovir?
Prodrug of acyclovir. Acyclovir is an acyclic nucleoside analogue of deoxyguanosine that is selectively
phosphorylated by the virus-encoded thymidine kinase to its monophosphate form.
Cellular enzymes then convert the monophosphate to the active antiviral acyclovir
triphosphate, which inhibits viral DNA synthesis by incorporation into viral DNA,
resulting in chain termination
What are the major contraindications for Valacyclovir?
Hypersensitivity
What are the black box warnings for Valacyclovir?
None
What are the common adverse drug reactions for Valacyclovir?
Malaise, Headache, Nausea, Neutropenia, Nasopharyngitis, Increased LFTs
What are the rare but serious adverse drug reactions for Valacyclovir?
Severe hypersensitivity, Renal failure, Thrombotic thrombocytopenic purpura
What are the key counseling points for Valacyclovir?
Seek medical attention if decreased urination, unusual bruising or bleeding, blistering skin rash, or shortness of breath. Symptoms should improve within 2-3d; if they worsen, seek follow-up with HCP. If using for prophylaxis, this medication should reduce the number of breakouts. Maintain adequate hydration during therapy to prevent renal complications.
