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NURS 252 (Pharmacology 2) > Antiviral drugs > Flashcards

Antiviral drugs Flashcards

1
Q

Why are viruses difficult to kill?

A

Because they live inside the cells. Any drug that kills viruses may also kill cells

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2
Q

Name 9 types of viruses and the diseases they cause

A

Poxviruses: Smallpox
Adenoviruses: Sore throat and conjunctivitis
Papovaviruses: Warts
Orthomyxoviruses: Influenza
Coronaviruses, rhinoviruses: Resp infections
Rotaviruses, Norwalk-like viruses: Gastroenteritis
Retroviruses: HIV/AIDS
Herpesviruses: Herpes
Hepadnaviruses: Hepatitis

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3
Q

What do antiviral drugs do?

A

Kill or suppress the virus by destroying virions or inhibiting the ability of viruses to replicate; controlled by current antiviral therapy

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4
Q

Name 6 viruses currently controlled by antiviral therapy

A

Cytomegalovirus (CMV)
Hepatitis viruses
Herpesviruses
HIV
Influenza
Respiratory syncytial virus (RSV)

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5
Q

What are the key characteristics of antiviral drugs?

A

Able to enter the cells that are infected with the virus
Interfere with viral nucleic acid synthesis and/or regulation
Prevent the fusion process
Some stimulate the immune system

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6
Q

T/F: Opportunistic infections are only caused by viruses

A

False: It can be other viruses, fungi or protozoa

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7
Q

What is the difference between antiviral drugs and antiretroviral drugs?

A

Antiviral drugs are used to treat infections caused by viruses other than HIV
Antiretroviral drugs are used to treat infections caused by HIV

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8
Q

Name the 7 types of Herpesviridae

A

Herpes simplex virus (HSV) 1: Oral herpes
HSV 2: Genital herpes
Human Herpesvirus (HHV) 3, aka varicella-zoster virus (VZV): Chickenpox and shingles
HHV 4: Epstein-Barr virus
HHV 5: CMV
HHV 6 and HHV 7
HHV 8: Kaposi’s sarcoma

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9
Q

What drugs are used to treat Shingles (HHV 3)?

A

Acyclovir
Zostavax

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10
Q

When are best results generally seen when taking acyclovir?

A

Best results are seen when it’s started within 72 hours of symptom onset

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11
Q

What is a possible complication of shingles

A

Post-herpetic neuralgia

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12
Q

What is the MOA of antiviral drugs?

A

Most work by blocking the activity of a polymerase enzyme that stimulates the synthesis of new viral genomes

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13
Q

What are the indications of antiviral drugs?

A

Influenza
HSV, VZV
CMV
Hep A, B, C

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14
Q

What is a common side effect of antiviral drugs?

A

Healthy cells are often also killed, resulting in serious toxicities

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15
Q

What is amantadine HCL? (Which influenza, adverse effects)

A

It’s a narrow spectrum antiviral that’s only active against influenza A
CNS effects: Insomnia, nervousness, light-headedness,
GI effects: Anorexia, nausea
Others: Orthostatic hypotension, blurred vision

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16
Q

What is contraindication
for amantadine HCL

A

Do not give to lactating mothers and children <12 years

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17
Q

What is acyclovir? (Forms, indications)

A

Used to suppress replication of HSV 1, HSV2, and VZV
Medication of choice for treatment of initial and recurrent episodes
Oral, topical and parenteral forms

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18
Q

What is a consideration of Acyclovir?

A

If given IV, it must be given over an hour to prevent kidney damage

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19
Q

What is ganciclovir HCL?(Indications and forms)

A

Used to treat infections caused by CMV
Oral and parenteral forms
Can cause CMV retinitis

20
Q

What must you do before administering ganciclovir?

A

Obtain a CBC w diff
Bone marrow produces WBCs

21
Q

What is a dose-limiting toxicity consideration for ganciclovir?

A

Bone marrow suppression

22
Q

Name 2 neuraminidase inhibitors and their indications
(Influenza)

A

Oseltamivir phosphate and zanamivir
Active against influenza A and B

23
Q

When should treatment with neuraminidase inhibitors begin?

A

Treatment should begin within 2 days of influenza symptom onset

24
Q

What are the forms and adverse effects of Oseltamivir phosphate?

A

Oral use only
Nausea and vomiting

25
Q

What are the forms and adverse effects of zanamivir?

A

Inhalation drug
Diarrhea, nausea and sinusitis

26
Q

T/F: Zanamivir can be used prophylactically for influenza A or B

A

False: Only oseltamivir can be used prophylactically. Zanamivir is only used for active treatment of influenza

27
Q

What is the leading cause of chronic liver disease and the most common reason for liver transplants?

A

Hepatitis C

28
Q

What is ribavirin and what do the 2 forms treat?

A

Antiviral drug
Oral form used for treatment of Hep C
Inhalation form used for hospitalized infants with RSV infections

29
Q

When is ribavirin contraindicated?

A

Contraindicated in pregnant women and their male sexual partners
Pregnant nurses cannot administer it either.

30
Q

How is HIV transmitted

A

Sexual activity, IV drug use, perinatal transfer from mother to child

31
Q

How many people worldwide are infected by HIV

A

Approximately 36.9 million people

32
Q

What are the 4 stages of HIV infection?

A

1: Asymptomatic infection (swollen lymph nodes)
2: Early, general symptoms of disease (fever, rash, night sweats, weight loss {less than 10% of overall weight})
3: Moderate symptoms (Weight loss more than 10% of overall weight, diarrhea, more opportunistic infections, changes in cbc)
4: Severe symptoms, including AIDS-defining illnesses, often leading to death
They symptoms of the stages are cumulative

33
Q

What are Reverse transcriptase inhibitors and what are the two sub-classes?

A

They block the activity of the enzyme reverse transcriptase, preventing production of new viral DNA
Nucleoside reverse transcriptase inhibitors (NRTI)
Non-nucleoside Reverse transcriptase inhibitors (NNRTI)

34
Q

Name the 4 other antiretroviral drugs

A

Protease inhibitors: Inhibit protease enzyme
Fusion inhibitors: Inhibit viral fusion
Entry inhibitor: CCR5 co-receptor antagonists (maraviroc)
Integrase inhibitor: Raltegravir K

35
Q

What is indinavir?

A

Protease inhibitor that’s used in monotherapy or combination

36
Q

What are some considerations when taking indinavir?

A

If possible, administer without food because protein fatty foods reduce absorption
Drink with lots of fluids to reduce risk of kidney stones (>1.5L)

37
Q

What is zidovudine?

A

NRTI
The first anti-HIV med that showed the best promise during AIDS epidemic
Also effective against maternal-newborn transmission of virus

38
Q

What are some considerations when taking zidovudine?

A

Major dose limiting adverse effect of bone marrow suppression
Often used in combination with Didanosine to avoid the above adverse effect

39
Q
A
40
Q

What is enfuvirtide?

A

Fusion inhibitor that suppresses the fusion process whereby A virion attached to the outer membrane of a host T cell before entry into the cell and subsequent viral replication
Used in combo with other antiretroviral drugs
Currently only available in injectable forms

41
Q

What are considerations regarding adverse effects of antiretroviral drugs?

A

There are numerous adverse effects that vary with each med
The main goal is to find the regimen that will best control the infection while having a tolerable adverse effect profile

42
Q

What is chemoprophylaxis for occupational exposure to HIV

A

Tenofovir (NRTI) + Lamivudine (NRTI) + Raltegravir (integrase inhibitor)
Begin blood testing within 72 hours post exposure

43
Q

What are four other viral infections?

A

Avian influenza (bird flu)
West nile virus
Severe acute resp syndrome (SARS)
H1N1 influenza (Swine flu)

44
Q

What is a precaution for patients when applying ointments or solutions?

A

They should wear gloves or finger cots

45
Q

T/F: Antiviral medications are cures

A

False: The main goal is to help manage symptoms

NURS 252 (Pharmacology 2) (23 decks)

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