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Unit 3 Micro and Immunology > Antiviral Drugs > Flashcards

Antiviral Drugs Flashcards

1
Q

What are 2 “virucidal” virus treatments?

A

Detergents and Cryotherapy

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2
Q

What are three types of virus treatments?

A

Virucidal, Immunomodulary, antivirals

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3
Q

What is an example of immunomodulary virus treatments? What is the goal of the treatment?

A

Example: Pegylated Interferon
Goal: Stimulate the intrinsic immune system

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4
Q

What are 4 classes of antivirals?

A

1- nucleoside analogs
2- non- nucleosides
3- protease inhibitors
4- entry inhibitors

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5
Q

Which antivirials are the most effective?

A

“Nucs” and “Non nucs”

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6
Q

Which type of antivirals are no longer used?

A

Antivirals inhibiting uncoating of the virus

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7
Q

What are the key viral function targets of antivirals?

A

1- Entry
2- Genome replication
3- Assembly
4- Release from the Cell

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8
Q

Why is there a general lack of “broad spectrum” antivirals?

A

Specificity of antivirals is a problem. Typically antivirals tend to target one function of one virus. Not universal.

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9
Q

What can happen when a drug is cleared from an individual’s system? What is done to prevent this?

A

Viral rebounding. Leads to need for life-long therapy in some cases.

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10
Q

Can resistance mutations exist in a patient before drug treatment?

A

Yes

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11
Q

How does antivirals lead to increased drug resistance?

A

Drug treatment selects for resistant virus strains

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12
Q

What are 4 factors leading to emergence of resistant variants?

A

1- High rate of virus replication
2- High Mutation rate (RNA»DNA)
3- High selective drug pressure
4- Immunosuppression of the host

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13
Q

Which of these counters resistnace to antivirals?
1- alleviating immunosuppression in the treated person
2- HAART
3- Targeting host functions

A

All of them!

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14
Q

Why is targeting host functions with antivirals dangerous?

A

Need to be careful of toxicity. Can be helpful is infected cells have a unique profile that can be a drug target and if virus mutations do not impact cellular genes.

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15
Q

What antiviral is used to treat HSV-1, HSV-2, and CZV?

A

Acyclovir

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16
Q

Who should be treated for a HSV-1, HSV-2, or CZV infection?

A

1- Neonates infected at birth
2- Immunodeficient
3- People with complicated HSV infections
4- People with frequent reoccurences

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17
Q

What is the structure of Acyclovir?

A

Nucleoside analog of guanosine

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18
Q

Explain the mechanism of Acyclovir

A

Phosphorylated once by a viral kinase. Phosphorylated twice more by host kinases. The triphosphate ACV inhibits viral DNA polymerase by competing with G for incorporation into DNA. It is a chain terminator

19
Q

What is the structure of ganciclovir?

A

nucleoside analog of guanosine

20
Q

What is the problem with ganciclovir treatment?

A

High toxicity, suppresses the bone marrow, mutagenic and teratogenic

21
Q

What virus is ganciclovir effective in treating?

A

CMV

22
Q

What are the two “broad spectrum” antivirals for DNA viruses?

A

Foscarnet and Cidovir

23
Q

How are Foscarsnet and Cidofovir administered?

A

IV only

24
Q

What viruses is foscarnet effective against?

A

all the Herpesviruses

25
Q

What viruses is cidofovir effective against?

A

Herpesviruses, adenoviruses, papillomavirues, poxvirus

26
Q

Where does the most toxicity occur with Foscarnet and Cidofovir?

A

Kidneys

27
Q

Drugs designed for what, are used to treat HBV?

A

HCV and HIV

28
Q

For people with HBV, who should be treated?

A

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

29
Q

What are the antivirals used to treat influenza?

A

Zanamivir and Oseltamivir

30
Q

What is the main treatment option for people who need treatment for HBV?

A

PEG-IFN-alpha

31
Q

What is the structure and function of Zanamivir and Oseltamivir?

A

Sialic acid analogs that inhibit viral neuraminidase. Virions remain attached to the cell.

32
Q

What is the “broad spectrum” RNA antiviral?

A

Ribavirin

33
Q

What is the structure of ribavirin?

A

nuceoside analogu of guanosine

34
Q

How is ribavirin formulated?

A

oral, IV and aerosole

35
Q

What is Ribavirin approved for used against?

A

HCV and RSV

36
Q

Which antiviral has a lot of off label use?

A

Ribavirin

37
Q

How is HCV treated?

A

combined therapy of Peg-interferon-alpha with Ribavirin

38
Q

Problem with HCV therapy?

A

Not all HCV genotypes respond to drugs

39
Q

Which hepatitis virus has awful treatment side effects?

A

HCV

40
Q

What are two alternative treatments for HCV? Are they approved yet?

A

Sofosbuvir and Ledipasvir. They are not approved yet!

41
Q

What are the classes of anti-HIV drugs?

A 
1- Entry inhibitors
2- Nucleoside/tide RT inhibitor
3- Non-nucleoside RT inhibitor
4- Integrase inhibitor
5- Protease inhibitor
42
Q

What is critical in HIV treatment?

A

HAART (using multiple drugs in treatment that target different stages of viral replication) and compliance.

43
Q

What is cobicistat? What are its benefits?

A

a drug enhancer that inhibits CYP3A4 that breaks down drugs in the liver. Benefit is that it allows for fewer pills or doses.

Unit 3 Micro and Immunology (25 decks)

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