Antiviral and Antiretroviral Medications Flashcards
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amantadine (Symmetril): mechanism, indications and side effects
blocks uncoating of virus preventing penetration into host, Influenza A; CNS stimulation, insomnia, Grand Mal Seizures
rimantidine (Flumadine): mechanism, indications and side effects
blocks uncoating of virus preventing penetration into host, Influenza A; CNS stimulation, insomnia, Grand Mal Seizures (rimantidine is significantly more active than amantadine)
oseltamivir (Tamiflu): mechanism, indications
Neuraminidase inhibitor (cleaves budding viral progeny from cellular envolope attachment point prior to release), Influenza A or B, classic prodrug
ribavirin (Rebetol, Virazole) mechanism, indications, side effects
inhibits virus RNA polymerase, treatment of RSV; mutagenic, teratogenic, carcinogenic
trifluridine (Viroptic): mechanism, indications
incorporates viral DNA in place of thymidine causing formation of defective proteins; herpes simplex keratitis, keratoconjunctivitis
acyclovir (Zovirax): mechanism, indications
inhibits viral DNA polymerase preferentially; Primary and recurrent herpes in immunocompromised patients, VZV, HSV2
ganciclovir (Cytovene): mechanism, indications
inhibits viral DNA synthesis: CMV and treatment of CMV retinitis
famciclovir and valacyclovir indications
recurrent genital herpes *classic prodrugs: converted to penciclovir and acyclovir respectively as they pass through the intestinal wall
What are Interferons?
Family of naturally ocurring glycoproteins that interfere with the ability of viruses to infect cells (antiviral, cytotoxic, immunomodulatory actions)
What is the mechanism of action for interferons?
Not entirely understood, however it includes induction of host cell enzymes that inhibit viral RNA translation, ultimately leading to the degradation of viral mRNA and tRNA.
What are the most common indications for interferons?
Hepatitis B and C, multiple sclerosis
What are mechanisms of antiretrovirals?
inhibit viral attachment and entry, polymerase inhibitors, antibodies against viral envelop proteins (a marjor target is reverse transcriptase)
What are three subtypes of antiretroviral drugs for HIV?
nucleoside reverse transcriptase inhibitors, protease inhibitors, nonnucleoside reverse transcriptase inhibitors
What is HAART therapy for?
Treatment of HIV infection (Highly active antiretroviral therapy) “cocktails”
What are some side effects of antiretrovirals?
anemia, leukopenia and granulocytopenia, hepatotoxicity, peripheral neuropathy, pancreatitis
didanosine (Videx)
Nucleoside reverse transcriptase inhibitor (to treat HIV)
zidovudine (Retrovir) = “AZT”
Nucleoside reverse transcriptase inhibitor (to treat HIV)
indinavir (Crixivan)
Protease inhibitor used to treat HIV
nelfinavir (Viracept)
Protease inhibitor used to treat HIV
saquinavir (Invirase)
Protease inhibitor used to treat HIV
Describe the basic mechanisms of action of antiviral drugs.
*alter uncoating, polymerase inhibitors, inhibit viral protein synthesis
Name the 6 classes of antiretroviral drugs used to manage HIV infection.
integrase inhibitor, nucleotide reverse transcriptase inhibitors, protease inhibitors, nonnucleoside reverse transcriptase inhibitors, nucleoside reverse transcripatse inhibitors, fusion protein inhibitors
Discuss goals of medication therapy for patients with HIV infection.
prevent opportunitistic infections, prevent binding of HIV to CD4 sell surface molecules, and prevent uncoating, integration and viral protein sythesis
