Antiviral Drugs Flashcards by Erin Bright

What are two types of virucidal treatments

Detergents

2. cryotherapy

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What is an immunomodulatory treatment?

alpha interferon

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What are the four types of antivirals used ?

nucleoside analogs
nonnucleosides
protease inhibitors
entry inhibitors

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Name a drug that affects viral entry and what disease it is used to treat

-Enfuvirtide - HIV

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Nucleic acid synthesis inhibitors are primarily used to treat which two diseases?

Herpes virus and HIV

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In treating HIV, what specifically is targeted , in concerining the assembly and release step ?

-Protease inhibitors

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Influenza virus is treatable with zanamivir and oseltamivir, which both target the same step of virus replication - what is their target?

Neuramindase - cleaves sialic acid and releases virions from cell surface

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What antiviral is used to affect the host’s intrinsic immunity and what viruses does it target?

peg-interferon

- HCV, HBV

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what are two “broad spectrum” treatments for DNA viruses?

foscarnet=foscavir

cidfovir=vistide

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how does foscarnet/foscavir work? (to treat DNA viruses)

inhibit DNA polymerase

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what type of virus is foscarnet/foscavir effective against? (to treat DNA viruses)

all herpesvirus

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what are two negatives of using foscarnet/foscavir and cidofovir/vistide? (to treat DNA viruses)

can only be administered via IV

toxic to kidneys

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what viruses are cidofovir/vistide active against?

herpesvirus
adenovirus
papillomavirus
pox virus

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what are the current drug options for hep B?

Peglyated interferon alpha
Entecavir=baraclude
Tenoforvir disoproxil fumarate=viread

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who should be treated for Hep B?

People with chronic active HBV disease
People co infected with HCV and/or HIV
People with progressing to cirrhosis, liver failure or hepatocellular carcinoma

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what is the mechanism of action for the drugs treating influenza virus?

both are sialic acid analogs that inhibit viral neuraminidase causing the virion to stay attached to the cell and not be able to infect other cells

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who should be treated for the influenza?

severely ill people
children younger than 2
adults over 65
pregnant women
immunosuppressed people
anyone suspected to have influenza

list characteristics about Ribavirin

“broad spectrum” for RNA viruses
approved against HCV and RSV
can be given orally, IV or aerosol

what is the current treatment for hep C virus?

combination peg-interferon-alpha with ribavirin

what is the treatment for hep C with peg-interferon alpha considered difficult and complicated?

can cause flu like symptoms, anemia, neutropenia, rashes, hair loss, depression…
people want to stop taking them

AZT (old HIV treatment) is a nucleoside analog of..?

thymidine

cidofovir/vistide (treatment for DNA viruses) is a nucleoside analog of…?

cytosine

what are the 5 anti HIV drug classes?

entry inhibitor
nucleoside/tide RT inhibitor
non nucleosdie/tide RT inhibitor
integrase inhibitor
protease inhibitor

what is cobicisat? (component of the new HIV treatment that can be taken in 1 pill)

it is liver enzyme enhancer

it boosts the other components in the treatment by preventing their break down in the liver

Describe the specificity of antivirals?

Most only target functions of one virus

Are most antivirals reversible or irreversible?

Reversible - competitive inhibitors

What does it mean that a virus rebounds after viral therapy?

Virus replication can resume when drug is cleared, and so treatment may need to be lifelong

Does resistance to an antiviral develop after treatment with the drug?

No - often exists before drug treatment

What are four factors favoring the emergence of resistance strains?

- high rate of replication - high mutation rate (RNA>>DNA) - high selective drug pressure - long term treatments - immunosuppressed can't clear viruses

What are three ways we can counter resistance to antivirals?

1. alleviate immunosuppression in a treated person 2. combine drugs with different targets - need them to synergize 3. Target host functions

What two infections, is the standard of care combining multiple synergistic treatments?

HCV and HIV

In order to treat zoster with an antiviral, what is the protocol?

Treatment only works within 3 days of appearance of rash

Acyclovir is a nucleoside analog of _____

Guanosine

What is the effectivity of acyclovir?

HSV1=HSV2>>>VZV

What is the trade name of acyclovir?

zovirax

What are some names of derivatives of acyclovir?

Valtrex, denavir, famvir

What is acyclovir's mechanism of action?

1. Enters cell 2. Phosphorylated by viral TK - Specific for infected cells with herpes only 3. Host kinases add 2nd & 3rd Phosphates 4. GTP is recognized by viral DNA polymerase and is added to viral DNA 5. No hydroxyl group left for further addition – chain terminator

Ganciclovir is a nucleoside analog of ____

guanosine

What is ganiclovir used to treat?

CMV

What is the mechanism of ganciclovir?

Similar mechanism as acyclovir, except it can be incorporated into host genome as well - TOXIC

Who should be treated with ganciclovir?

- BM and organ transplant patients - immunosuppressed and people with active CMV - CMV retinitis