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pharm exam 3 > Antiviral > Flashcards

Antiviral Flashcards

1
Q

MOA Acyclovir

A
  • guanosine analogue
  • required phosphorylation and activation by viral thymidine kinase
  • inhibits DNA synthesis by competing with dGTP
  • concentrated in viral-infected cells
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2
Q

resistance to Acyclovir

A

develop due to decrease in viral thymidine kinase

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3
Q

route of administration of Acyclovir

A
  • oral, topical, IV
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4
Q

What is Valacyclovir

A
  • oral pro-drug; converted to acyclovir
  • higher bioavailability
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5
Q

DOC: HSV (genital herpes; herpes keratitis)

A

Acyclovir/Valacyclovir

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6
Q

Toxicity of Acyclovir/Valacyclovir

A
  • Nephrotoxicity with high IV doses
    • hydration is important
  • safe in pregnancy
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7
Q

MOA: Docosanol (Abreva)

A
  • inhibits viral fusion to host cell plasma membrane so virus can’t get into cell
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8
Q

use of : Docosanol (Abreva)

A
  • OTC for cold sores
    • herpex simplex: topical
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9
Q

MOA: of Ganciclovir/Valganciclovir

A
  • Guanosine analogue
  • activated by viral kinases
  • inhibits DNA polymerase
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10
Q

route of administration of Ganciclovir

A
  • occular implant, oral, or IV
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11
Q

route of administration of Valganciclovir

A

oral

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12
Q

DOC: CMV

A
  • Ganciclovir/Valganciclovir
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13
Q

DOC: VZV

A

Acyclovir/valacyclovir

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14
Q

Theraputic use of Ganciclovir/Valganciclovir

A
  • CMV/herpes
  • CMV retinitis
  • life threatening CMV
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15
Q

contraindication of use with Ganciclovir/Valganciclovir

A

pregnant women- category C drug

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16
Q

toxicity of Ganciclovir/Valganciclovir

A
  • myelosuppression: leukopenia
  • CNS: HA, confusion, sz
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17
Q

MOA: Foscarnet (Foscavir)

A
  • directly inhibits DNA and RNA polymerase, reverse transcriptase
  • **does NOT require phosphorylation for activity
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18
Q

DOC: CMV encephalitis

A

Foscarnet + ganciclovir

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19
Q

treatment of CMV retinitis in ganciclovir resistant

A
  • Foscarnet
  • Cidofovir
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20
Q

toxicity of Foscarnet

A

renal toxicity

21
Q

route of administration of Foscarnet

A

IV

22
Q

MOA of Cidofovir

A
  • inhibits viral DNA polymerase
  • phosphorylation to an active drug is independent of viral enzymes
23
Q

Alternate treatment of HSV

A
  • Ganiclovir/valganciclovir
  • Docosanol
  • Foscarnet
  • Cidofovir
24
Q

toxicity of cidofovir

A

dose dependent nephrotoxicity

25
Q

MOA of Oseltamivir (Tamiflu) and Zanamivir (Relenza)

A

Neuraminidase inhibitor, block release of virus from cells

26
Q

DOC: Influenza A and B

A
  • Oseltamivir (Tamiflu): patients > 1 yr
  • Zanamivir (Relenza): patients > 7 yrs
27
Q

route of administration of Oseltamivir (Tamiflu) and Zanamivir (Relenza)

A
  • Oseltamivir (Tamiflu): oral
  • Zanamivir (Relenza): inhaler
28
Q

MOA of Amantadine/Rimantadine

A

inhibit uncoating of viral RNA within infected host cells, thereby preventing replication

29
Q

alternate treatment of Influenza A

A

Amantadine/Rimantadine

30
Q

MOA of Ribavirin

A
  • guanosine analogue
  • phosphorylated by host enzymes
31
Q

DOC: RSV

A

Ribavirin

32
Q

DOC: Hepatitis C

A
  • Interferon alpha2B + Ribavirin (+ boceprevir if needed)
33
Q

route of administration of Ribavirin

A
  • aerosol
  • IV
  • oral
34
Q

toxicity of Ribavirin

A
  • oral: hemolytic anemia
  • aerosol: respiratory depression, cardiac arrest
  • IV: psychiatric
35
Q

what do you have to be concerned when prescribing Ribavirin to women

A

Ribavirin is Teratogenic: category X drug: women should no concieve for at least 6 months after exposure to drug

**occupational exposure problematic

36
Q

MOA of interferon-alpha2b

A
  • A,B: blocks viral entry
  1. blocks transcription and translation of mRNA
  2. blocks viral replication
  3. blocks viral processing
  4. blocks viral assembly and release
37
Q

route of administration of interferon-alpha2b

A
  • IV
  • IM
  • Subcutaneous
38
Q

alternate treatment of Hepatitis B

A
  • interferon-alpha2b
  • adefovir
  • Entecavir
39
Q

DOC: hepatitis B

A

Lamivudine

40
Q

toxicity of interferon-alpha2b

A
  • flu-like symptoms
  • CNS: depression and suicide - prescribe antidepressants before initiating interferon therapy
41
Q

MOA: Boceprevir

A
  • block activity of a serine protease needed for replication of Hepatitis C virus
42
Q

route of administration of Boceprevir

A

oral

43
Q

toxicity of Boceprevir

A
  • drug interaction: inhibitor of CYP3A4
  • anemia
44
Q

route of administration of Lamivudine, Adefovir, Entecavir

A

oral

45
Q

MOA of Lamivudine

A

inhibits hepatitis B polymerase

46
Q

MOA of adefovir

A

inhibits Hep B DNA polymerase

47
Q

toxicity of Adefovir

A

renal toxicity

48
Q

MOA of Entecavir

A

guanosine analogue

pharm exam 3 (7 decks)

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