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Antiviral Drugs Flashcards

1
Q

State 1 Antiviral drug that inhibits viral Attachment and the dx it’s used to treat.

A

Maraviroc—> used to treat HIV&AIDS

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2
Q

State 1 Antiviral drug that inhibits viral entry and the dx it’s used to treat

A

Enfurvitide —> used to treat HIV& AIDS

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3
Q

State 2 drug that inhibits viral uncoating and the dx it’s used to treat

A

✓Amantadine —> used to treat influenza A

✓ Rimantadine —> used to treat influenza A

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4
Q

State 7 antiviral drugs that inhibits viral replication and the dx it’s used to treat

A

✓Acyclovir —> used to treat Herpes simplex, varicella zoster and cytomegalovirus

✓Valacyclovir—> used to treat Herpes simplex, varicella zoster and cytomegalovirus

✓ Ganciclovir —-> Cytomegalovirus

✓ Penciclovir —> Herpes simplex

✓Famciclovir—> Herpes simplex,
varicella-zoster

✓ Lamivudine —-> Hepatitis B (chronic cases, HIV type 1

✓ Ribavirin

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5
Q

State 1 Antiviral drug that inhibits viral protein synthesis and the dx it’s used to treat

A

Interferon- Alpha —> used to treat
✓Hepatitis B and C
✓human herpesvirus 8
✓ papilloma virus
✓Kaposi sarcoma

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6
Q

State 1 Antiviral drug that inhibits viral release and the dx it’s used to treat

A

Oseltamivir —> used to treat influenza A.

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7
Q

State 1 Antiviral drug that inhibits viral release and the dx it’s used to treat

A

Oseltamivir —> used to treat influenza A.

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8
Q

Anti herpes virus drugs is subdivided into —— and —–

A

Nucleoside Analogues and others

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9
Q

State 7 examples of nucleoside analogues used to treat herpes virus infections.

A

✓Idoxuridine
✓ Trifluridine
✓ Acyclovir
✓Valacyclovir
✓Famciclovir
✓Ganciclovir
✓Valganciclovir

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10
Q

State 3 examples of Others drugs apart from the Nucleoside Analogues used to treat herpes virus infections.

A

✓ Cidofovir
✓Foscarnet
✓Fomivirsen

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11
Q

State 3 examples of Others drugs apart from the Nucleoside Analogues used to treat herpes virus infections.

A

✓ Cidofovir
✓Foscarnet
✓Fomivirsen

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12
Q

Anti Infleunza virus drugs are subdivided into —– and —–

A

Neuraminidase Inhibitors and
Non neuraminidase inhibitors.

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13
Q

State 2 Examples of Neuraminidase inhibitors used to treat influenza virus:

A

✓Oseltamivir
✓Zanamivir
✓Peramivir

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14
Q

State 2 examples of Non Neuraminidase inhibitors used to treat Infleunza virus:

A

✓Amantidine
✓Rimantidine

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15
Q

Ribavirin is effective against a broad range of DNA and RNA viruses so it can be used to treat influenza, thus it’s a first line drug for the treatment of inflenza!!!

A

False

Ribavirin is effective against a broad range of DNA and RNA viruses so it can be used to treat influenza however it IS NOT the first line drug for the treatment of inflenza

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16
Q

State 5 drugs used to treat Hepatitis B:

A

✓Lamivudine
✓ Adefovir Dipivoxil
✓Tenofovir
✓Telbivudine
✓Pegylated Interferon

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17
Q

State 5 drugs that’s used to treat hepatitis C

A

✓Ribavirin
✓ Interferon α
✓Pegylated Interferon
✓Boceprevir

✓Daclatasvir

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18
Q

State 3 examples of Antiviral drugs used to treat COVID 19

A

✓Remdesivir
✓Paxlovid
✓Monoclonal antibodies

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19
Q

Describe the Mechanism of action of Idoxuridine

A

MOA: Faulty DNA Production: Idoxuridine work by incorporating themselves into the viral DNA during replication. This leads to the formation of faulty DNA that is unstable and prone to breaking down — disruption of viral lifecycle.

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20
Q

Uses of Idoxuridine

A

To treat Herpes simplex keratitis

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21
Q

Side effects of Idoxuridine

A

Ocular irritation

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22
Q

Disadvantage of Trifluridine??

A

it has low virus selectivity meaning that they not only affect viral DNA replication, but can also interfere with host cell DNA synthesis —-> resulting in Toxicity.

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23
Q

State 1 Use of Trifluridine

A

In India trifluridine eye drop is approved for treatment of H. simplex keratitis

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24
Q

Describe the MOA of acyclovir

A

Acyclovir itself is an inactive drug. It’s an deoxiguanosine analogue (i.e analogue of guanosine found in DNA) that requires an enzyme, i.e the thymidine kinase specifically found in virus to convert it into its active form i.e acyclovir monophosphate.

Acyclovir monophosphate is then converted into acyclovir triphosphate by Cellular kinases

The Acyclovir triphosphate;
✓competes with normal nucleotide and gets Incorporated into viral DNA, stopping DNA strand elongation.

✓Irreversibly blocks the action of DNA polymerase, preventing viral replication.

Acyclovir is highly selective because it depends
on thymidine kinase an enzyme that’s only found in viruses for its initial activation.

This ensures that the active form of the drug is only generated in cells that have been I fevted with the virus.

Because it’s highly toxic to infected cells but has little to no toxicity on host cells we say it has a high chemotherapeutic index!!

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25
Describe the spectrum of activity of acyclovir
Herpes simplex virus type 1 (HSV-1) is most sensitive, followed by HSV-2, then Varicella zoster virus (VZV) and Epstein-Barr virus (EBV). Cytomegalovirus (CMV) is practically unaffected by acyclovir.
26
Describe the Mechanism of resistance to acyclovir
•Herpes simplex virus resistance develops due to mutations in thymidine kinase---> decreased activity of these enzymes •VZV resistance occurs due to changes in viral enzyme ---> decreased affinity of the enzymes to acyclovir
27
State 6 Diseases that can be treated with Acyclovir
✓Genital Herpes (HSV-2) ✓Mucocutaneous H. simplex ✓ Herpes Simplex Encephalitis (HSV-1) ✓ Herpes Simplex Keratitis (HSV-1) ✓ Herpes Zoster (Shingles): ✓ Chickenpox:
28
Classify and state the side effects associated with Acyclovir
✓Route-Dependent Adverse Effects and ✓ Dose Dependent Adverse Effects Route-Dependent Adverse Effects includes ; •For Topical: ✓ stinging and burning at the the site of application • For Oral: ✓ headache ✓ nausea ✓malaise and ✓ mild CNS effects may occur For Intravenous: ✓ Rashes ✓Sweating ✓Vomiting ✓ hypotension Dose Dependent Adverse Effects Includes; •Dose-Dependent Kidney Toxicity •mild Neurological symptoms e.g ✓tremors ✓lethargy) • Severe Neurological symptoms e.g ✓hallucination ✓Seizures ✓ Coma etc
29
Studies has shown that Acyclovir is associated with some teratogenic effects True or False??
False. Acyclovir has no teratogenic effect
30
Write a short introduction for Valacyclovir
Valacyclovir is a prodrug of acyclovir, meaning it is converted into acyclovir in the body. Due of the presence of peptide transporters for this drug in the intestine, it has better oral absorption resulting in greater bioavailability (55–70%) compared to acyclovir (20%). This higher absorption ---> higher bioavailability---> more effective oral treatment
31
State 3 disease conditions Valacyclovir can be used to treat
✓Genital herpes simplex (first episode, recurrences, suppressive therapy) ✓Orolabial herpes (cold sores) ✓Herpes zoster (shingles); It is the first line drug for the treatment of herpes zoster.
32
What dx is Valacyclovir used as the first line treatment
Herpes zoster (shingles)
33
Valacyclovir is a pro drug to ----- while famciclovir is a pro drug to -----
Acyclovir and penciclovir respectively. Valacyclovir is a pro drug to acyclovir while famciclovir is a pro drug to penciclovir
34
Describe the Mechanism of action of famciclovir
Mechanism Of Action: Like Acyclovir, Famciclovir requires Thymidine kinase, i.e an enzyme found in viruses to be converted into its active form ( This is a form of selective toxicity because this means that it's only in virus infected cells it'd get activated ) The active form inhibits DNA polymerase, thus interfering with viral replication.
35
State 3 dx conditions for which Famciclovir is effective against
✓Herpes simplex virus (HSV) ✓Herpes zoster virus (VZV) ✓ it also has some activity against hepatitis B virus (HBV) , however it's less effective than lamivudine
36
Lamivudine is less effective than Famciclovir for the treatment of Hep B True or false
False Lamivudine is actually more effective than Famciclovir for the treatment of Hep B however it's not a first line drug for the treatment of Hep B
37
Famciclovir is also effective against acyclovir resistant strains of HSV and VZV True or false
False. It is not effective against acyclovir resistant strains of HSV and VZV, probably because the mechanism of resistance for acyclovir and famciclovir is similar i.e mutation of the Thymidine kinase, an enzyme found in these viruses and required for the activation of the drugs
38
Side effects of Famciclovir
✓headache ✓nausea ✓loose motions ✓ itching ✓ rashes and ✓ mental confusion
39
How does Ganciclovir differ from acyclovir??
1. unlike acyclovir, it is effective against all herpes viruses, with its effect against cytomegalovirus (CMV) being the strongest
40
Give a brief description of Ganciclovir
Ganciclovir is similar to acyclovir however, it is effective against all herpes viruses, with its effect against cytomegalovirus (CMV) being the strongest Like acyclovir, it requires activation inside infected cells by viral thymidine kinase. Once activated, it inhibits viral DNA polymerase, accumulating in high concentrations in CMV-infected cells.
41
State 1 side effect of Ganciclovir
Bone marrow depression
42
Due to the side effects of Ganciclovir, what kind of pts is this drug reserved for??
Because of it's dangerous side effects so it is not used for mild infections. Instead, it is reserved for serious CMV infections. This is usually seen in people with weak immune systems (e.g AIDS patients or organ transplant recipients) Since these patients are at higher risk of severe CMV complications, due to low immunity, the benefits of ganciclovir overrides the risk of side effects.
43
Cidofovir is a nucleotide analogue that is not effective against many DNA viruses e.g HSV, CMV, pox, and adenoviruses True or false
False Cidofovir is a nucleotide analogue that is effective against many DNA viruses e.g HSV, CMV, POX virus and ADENOVIRUSES
44
What are some differences between cidofovir and Ganciclovir?
Unlike ganciclovir ✓ it doesn't need viral enzymes to be activated and is converted to its active form by cellular enzymes. ✓The active form of cidofovir doesn't concentrate in infected cells,
45
It is NOT effective for the treatment of some viruses which are resistant to acyclovir or ganciclovir True or false
False It is effective for the treatment of some viruses which are resistant to acyclovir or ganciclovir e.g ✓ Acyclovir-Resistant HSV ✓Ganciclovir-Resistant CMV.
46
Give examples of drugs resistant strains which cidofovir can be used to treat
✓Acyclovir-Resistant HSV ✓Ganciclovir-Resistant CMV.
47
Which drug must be taken with probenecid??
Cidofovir
48
1. Why must probenecid be administered with cidofovir 2. How is it administered
1.To Reduce nephrotoxicity and increase bioavailability. 2. Orally
49
Is cidofovir best administered orally or Intravenously??
Intravenously, this is because it is not absorbed orally.
50
State the uses of cidofovir
✓ For treatment of CMV retinitis in AIDS patients, especially when ganciclovir doesn't work, as well as acyclovir-resistant herpes simplex. ✓ It can also be used topically for treatment of anogenital warts.
51
State the side effects associated with the use of cidofovir, highlighting the major effects and the minor effects
•Major side effects ✓ kidney damage, which is dose-dependent i.e the higher the dose the more the likelihood of kidney damage •Other side effects ✓Gastrointestinal issues ✓Hypersensitivity ✓flu-like symptoms.
52
State 1 advantage and disadvantage of foscarnet
A key advantage of foscarnet is that resistance of virus to it is minimal, Disadvantage Foscarnet has low viral selectivity i.e it is toxic to both viral cells and host cells.
53
List viruses that Foscarnet is effective against
✓Herpes viruses, including resistant strains e.g HSV resistant to acyclovir, CMV resistant to ganciclovir ✓ HIV.
54
State the uses of Foscarnet
Due to its high toxicity, it is administered IV for the treatment of: ✓CMV retinitis and other CMV infections in AIDS patients; it's effect are similar to Ganciclovir but it has more side effects ✓ Acyclovir-resistant herpes simplex (HSV-2) in AIDS patients. ✓ varicella-zoster (VZV) infections in AIDS patients. .
55
Why's Foscarnet great for use in HIV / AIDS patients??
When used to treat CMV, herpes simplex, or varicella-zoster infections in AIDS patients, foscarnet can lower HIV viral levels and may improve outcomes in patients receiving antiretroviral therapy.
56
State the side effects associated with the use of Foscarnet, highlighting the major and minor ones
•Major side effects ✓ Kidney damage causing a diabetes-like condition ✓ Acute renal failure. •Other side effects of foscarnet includes ✓ anemia, ✓phlebitis ✓tremors ✓convulsions ✓ symptoms related to low calcium levels.
57
Describe amantadine chemically
Chemically, it is a unique tricyclic amine that is not related to nucleic acid precursors, but it inhibits the replication of influenza A virus.
58
State 3 uses of Amantadine
✓Influenza A2 Prophylaxis: ✓Treatment of Influenza A2 ✓Treatment of parkinson’s Disease
59
State at least 5 side effects associated with the use of Amantadine
Amantadine is generally well tolerated, however it may cause ✓Nausea ✓ Anorexia ✓insomnia ✓Dizziness ✓ Nightmares ✓Difficulty concentrating ✓hallucinations ( rare) ✓Ankle swelling
60
State 4 contraindications associated with the use of Amantadine
✓Epilepsy ✓CNS diseases ✓gastric ulcers ✓pregnancy.
61
State 4 contraindications associated with the use of Amantadine
✓Epilepsy ✓CNS diseases ✓gastric ulcers ✓pregnancy.
62
State the route of adminstration for Oseltamivir
Oral
63
Describe the Mechanism of action of Oseltamivir
It is a prodrug that gets converted in the intestine and liver into its active form called oseltamivir carboxylate (bioavailability ~80%). This active form inhibits a viral enzyme called neuraminidase. blockage of neuraminidase with oseltamivir ---> prevents the release of new virus particles, thus decreasing/ preventing the spread of the virus
64
Describe the mechanism of resistance for Oseltamivir
Mutations in the neuraminidase enzyme ---> resistant to oseltamivir ---> ineffective treatment •However, some of these resistant viruses might still be treatable with zanamivir.
65
State the uses of Oseltamivir
✓ Treatment of Infleunza A and B ✓ Prophylaxis for inflenza A and B
66
State the Side effects of Oseltamivir
Side effects Common side effects: ✓ Nausea ✓Abdominal pain ✓ Headache ✓weakness ✓ Cough ✓Diarrhea ✓ Insomnia. ✓Skin reactions are rare but possible.
67
Route of administration of zanamivir
Inhalational
68
State the uses of zanamivir
✓ used as an alternative to oseltamivir for treating influenza A and B ✓ Prophylaxis for inflenza A and B
69
State the uses of zanamivir
✓ used as an alternative to oseltamivir for treating influenza A and B ✓ Prophylaxis for inflenza A and B
70
State the side effects of zanamivir highlighting it's major and minor side effects
•Major side effects ✓ bronchospasm, especially in asthmatics •Mild side effects: ✓ Headache ✓dizziness ✓Nausea ✓ rashes
71
Contraindication of zanamivir
It's Contraindicated in asthmatics
72
State the route of administration of peramivir
Intravenous
73
State the use of peramivir
To treat Infleunza A and B
74
State the side effects of peramivir
✓ Headache ✓dizziness ✓Nausea ✓ rashes
75
Ribavirin is a purine nucleoside analogue which is effective against a broad range of viruses True or false
True
76
Give some examples of the viruses Ribavirin is effective against.
For clarification it's effective against a various viruses , some of these includes ✓HEPATITIS ✓ Influenza A & B ✓ respiratory syncytial virus (RSV) ✓Measles ✓Herpes etc
77
State the uses of Ribavirin
✓Chronic hepatitis C – Oral ribavirin is usually used with pegylated interferon for 6–12 months. ✓RSV bronchiolitis in infants; This is administered via nebulization for high-risk children. ✓Severe influenza, measles, and herpes – Used in immunocompromised patients (not first-line).
78
Ribavirin is teratogenic True or False
True
79
State side effects associated with the use of Ribavirin
✓Anemia ✓bone marrow suppression ✓nausea ✓ CNS effects (dizziness, confusion) ✓Teratogenic (harmful in pregnancy). ✓Inhaled form may cause bronchospasm and mucosal irritation.
80
Describe interferons
Interferons are cytokines/ natural proteins produced by the body to fight viruses and tumors. They act at multiple steps of viral replication and boost immune responses
81
State and describe the types of interferons used in medicine
✓ Human interferons (IFNα2A and IFNα2B) ✓ Pegelated interferons •Human interferons (IFNα2A and IFNα2B) are produced using recombinant technology and administered via injection either IV or IM •Pegylated forms of interferon allow weekly dosing, thus they are designed for less frequent administration and have more sustained effects.
82
State the route of administration of human interferon
Injection either IV or IM
83
State the uses of interferon
✓Chronic Hepatitis B & C – Given alone or with ribavirin for 6–12 months. Pegylated IFNs work better than standard IFNs. ✓AIDS-related Kaposi’s Sarcoma ✓Genital warts (Condyloma Acuminata) – Used as injections for stubborn cases. ✓Herpes ✓ CMV ✓ Shingles – Less effective than acyclovir or ganciclovir. ✓Certain Cancers: e.g leukemia, lymphoma, and multiple myeloma.
84
State the uses of interferon
✓Chronic Hepatitis B & C – Given alone or with ribavirin for 6–12 months. Pegylated IFNs work better than standard IFNs. ✓AIDS-related Kaposi’s Sarcoma ✓Genital warts (Condyloma Acuminata) – Used as injections for stubborn cases. ✓Herpes ✓ CMV ✓ Shingles – Less effective than acyclovir or ganciclovir. ✓Certain Cancers: e.g leukemia, lymphoma, and multiple myeloma.

Pharmacology (3 decks)

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