Antiviral and Antiretroviral Medications

Question 1

Be sure to review the autoimmune lecture well

Answer 1

I did not create any flashcards for that lecture.

Question 2

amantadine (Symmetril): mechanism, indications and side effects

Answer 2

blocks uncoating of virus preventing penetration into host, Influenza A; CNS stimulation, insomnia, Grand Mal Seizures

Question 3

rimantidine (Flumadine): mechanism, indications and side effects

Answer 3

blocks uncoating of virus preventing penetration into host, Influenza A; CNS stimulation, insomnia, Grand Mal Seizures (rimantidine is significantly more active than amantadine)

Question 4

oseltamivir (Tamiflu): mechanism, indications

Answer 4

Neuraminidase inhibitor (cleaves budding viral progeny from cellular envolope attachment point prior to release), Influenza A or B, classic prodrug

Question 5

ribavirin (Rebetol, Virazole) mechanism, indications, side effects

Answer 5

inhibits virus RNA polymerase, treatment of RSV; mutagenic, teratogenic, carcinogenic

Question 6

trifluridine (Viroptic): mechanism, indications

Answer 6

incorporates viral DNA in place of thymidine causing formation of defective proteins; herpes simplex keratitis, keratoconjunctivitis

Question 7

acyclovir (Zovirax): mechanism, indications

Answer 7

inhibits viral DNA polymerase preferentially; Primary and recurrent herpes in immunocompromised patients, VZV, HSV2

Question 8

ganciclovir (Cytovene): mechanism, indications

Answer 8

inhibits viral DNA synthesis: CMV and treatment of CMV retinitis

Question 9

famciclovir and valacyclovir indications

Answer 9

recurrent genital herpes *classic prodrugs: converted to penciclovir and acyclovir respectively as they pass through the intestinal wall

Question 10

What are Interferons?

Answer 10

Family of naturally ocurring glycoproteins that interfere with the ability of viruses to infect cells (antiviral, cytotoxic, immunomodulatory actions)

Question 11

What is the mechanism of action for interferons?

Answer 11

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.

Question 12

What are the most common indications for interferons?

Answer 12

Hepatitis B and C, multiple sclerosis

Question 13

What are mechanisms of antiretrovirals?

Answer 13

inhibit viral attachment and entry, polymerase inhibitors, antibodies against viral envelop proteins (a marjor target is reverse transcriptase)

Question 14

What are three subtypes of antiretroviral drugs for HIV?

Answer 14

nucleoside reverse transcriptase inhibitors, protease inhibitors, nonnucleoside reverse transcriptase inhibitors

Question 15

What is HAART therapy for?

Answer 15

Treatment of HIV infection (Highly active antiretroviral therapy) “cocktails”

Question 16

What are some side effects of antiretrovirals?

Answer 16

anemia, leukopenia and granulocytopenia, hepatotoxicity, peripheral neuropathy, pancreatitis

Question 17

didanosine (Videx)

Answer 17

Nucleoside reverse transcriptase inhibitor (to treat HIV)

Question 18

zidovudine (Retrovir) = “AZT”

Answer 18

Nucleoside reverse transcriptase inhibitor (to treat HIV)

Question 19

indinavir (Crixivan)

Answer 19

Protease inhibitor used to treat HIV

Question 20

nelfinavir (Viracept)

Answer 20

Protease inhibitor used to treat HIV

Question 21

saquinavir (Invirase)

Answer 21

Protease inhibitor used to treat HIV

Question 22

Describe the basic mechanisms of action of antiviral drugs.

Answer 22

*alter uncoating, polymerase inhibitors, inhibit viral protein synthesis

Question 23

Name the 6 classes of antiretroviral drugs used to manage HIV infection.

Answer 23

integrase inhibitor, nucleotide reverse transcriptase inhibitors, protease inhibitors, nonnucleoside reverse transcriptase inhibitors, nucleoside reverse transcripatse inhibitors, fusion protein inhibitors

Question 24

Discuss goals of medication therapy for patients with HIV infection.

Answer 24

prevent opportunitistic infections, prevent binding of HIV to CD4 sell surface molecules, and prevent uncoating, integration and viral protein sythesis

Question 25

What are some opportunistic infections that oftentimes affect HIV/AIDS patients?

Answer 25

pneumocystis carnii, viral infections, candidiasis, cryptococcus, histoplasma, TB, CMV, EBV

Question 26

What is the mechanism of action for nonnucleoside reverse transcriptase inhibitors?

Answer 26

block reverse transcriptase but do not require bioactivation

Question 27

What is a primary difference between protease inhibitors and other drugs used to treat HIV?

Answer 27

They interfere with the action of HIV-infected cells whereas many of the others do not affect cells that are already affected.

Question 28

What are a few notable symptoms within the oral cavity of some HIV patients?

Answer 28

Linear gingival erythema, NUP, periodontitis

Question 29

What is the mechanism of action for nucleoside reverse transcriptase inhibitors?

Answer 29

inhibits viral enzyme reverse transcriptase (must be biotransformed/bioactivated to work) and have no effect on cells already containing HIV.