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Antiviral Drugs Flashcards

1
Q

what are the sites of action for Antiviral drugs?

A
  1. Entry/Attachment Inhibitors
  2. Nucleic Acid Synthesis Inhibitors
  3. Integrase Inhibitors
  4. Protease Inhibitors
  5. Neuraminidase Inhibitors
  6. Non-specific agents (interferons)
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2
Q

what are the prophylactic vaccinations?

A

MMR
Chicken Pox
Polio
Hep A and B
Influenza
HPV
Herpes Zoster
SARS COVID-19
RSV

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3
Q

what diseases are treated with immunoglobulins and how do they work?

A
  • measles hepatitis and rabies
  • block the penetration step of viral replication
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4
Q

what are the key drugs for Influenza A and B?

A

Oseltamivir
Peramivir
Zanamivir
Baloxavir

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5
Q

what is the MOA for Oseltamivir, Peramivir and Zanamivir?

A
  • inhibit neuraminidase, an enzyme the influenza virus needs to exit infected cells and spread
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6
Q

what is the route and adverse effects for Oseltamivir, Peramivir and Zanamivir?

A

Oseltamivir: inhaled; broncospasms
Peramivir: oral; GI upset
Zanamivir: IV; GI upset, dry mouth, drowsiness

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7
Q

what neuraminidase inhibitor for Influenza treatment is preferred during pregnancy?

A

Oseltamivir

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8
Q

what is the MOA for Baloxavir?

A

inhibits endonuclease activity of polymerase acidic protein in viral RNA polymerase complex; leading to decrease in gene transcription

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9
Q

what are the adverse effects of Baloxavir?

A

GI upset (oral)
bronchitis
sinusitis

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10
Q

what are the drugs used to treat HSV?

A

Acyclovir and Acyclovir Analogs

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11
Q

what is the MOA for Acyclovir?

A

acyclovir is activated to monophosphate then diphosphate and then acyclovir triphosphate, which blocks the virus’s DNA polymerase and acts as a chain terminator, stopping viral DNA from being built

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12
Q

what is Acyclovir used for and what are its routes of administration?

A

used to treat HVS-1, HVS-2 and varicella zoster and is give:
- topically for skin lesions
- oral
- IV for serious infections

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13
Q

what are the adverse effects for Acyclovir?

A

burning
mild pain
GI upset
headache
confusion
tremor
renal
thrombophlebitis

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14
Q

what are the Acyclovir Analogs + other drugs for herpes infections?

A

Valacyclovir
Famciclovir
Docosanol

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15
Q

what is Valacyclovir?

A

A prodrug that turns into acyclovir in the body for better oral absorption (54-70%) used for HSV, VZV and has the same side effects as acyclovir

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16
Q

what is Famciclovir?

A

a prodrug of penciclovir (topical for HSV-1) used orally for HSV, VZV and has side effects like GI upset, headache

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17
Q

what is Docosanol?

A

over-the-counter topical cream that works by blocking virus fusion with the host cell and used for orolabial herpes (cold sores)

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18
Q

what are the drugs used for cytomegalovirus (CMV) treatment?

A

Ganciclovir ( prodrug;Valganciclovir)
Foscarnet
Cidofovir
Letermovir
Maribavir

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19
Q

what is the MOA for Ganciclovir and prodrug Valganciclovir?

A

inhibits viral DNA polymerase

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20
Q

what is Ganciclovir/Valganciclovir used to treat?

A

gievn orally, intraocular or IV for CMV; herpetic keratoconjunctivitis

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21
Q

what are the adverse effects of Ganciclovir/Valganciclovir?

A

bone marrow suppression
anemia
nephrotoxicity

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22
Q

what is the MOA for Foscarnet?

A

inhibitor of DNA polymerase, RNA polymerase, & HIV reverse transcriptase to block DNA chain elongation

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23
Q

what is Foscarnet used for?

A

drug-resistant herpesviruses:
- CMV retinitis (especially if ganciclovir-resistant)
- Acyclovir-resistant HSV
- Acyclovir-resistant VZV

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24
Q

what are the adverse effects of Foscarnet?

A

nephrotoxicity
cardiotoxicity
**but less hematotoxicity than ganciclovir

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25
what is the MOA of Cidofovir?
inhibits viral DNA polymerase and causes viral DNA chain termination
26
what is Cidofovir used for?
CMV retinitis
27
what is a major risk of using Cidofovir?
extreme nephrotoxicity
28
what is the MOA for Letermovir?
Inhibits the CMV DNA terminase complex, which is essential for viral DNA packaging into new virus particles
29
what is Letermovir used for?
Prophylaxis (prevention) of CMV in transplant patients
30
what are the adverse effects of Letermovir?
GI upset Edema (fluid retention) Cough Headache
31
what is the MOA for Maribavir?
Inhibits pUL97 kinase, a CMV-specific enzyme involved in viral DNA replication
32
what is Maribavir used for?
refractory CMV infections (if no response to ganciclovir or foscarnet)
33
what are the adverse effects of Maribavir?
GI symptoms Fatigue *Less kidney toxicity than foscarnet * Less neutropenia than ganciclovir
34
what are the treatments for RSV (Respiratory Syncytial Virus)?
1. ribavirin 2. Palivizumab 3. RSV Vaccine
35
what is the MOA for Ribavirin?
- RMP (Ribavirin Monophosphate): inhibits inosine monophosphate dehydrogenase → reduces GMP synthesis - RTP (Ribavirin Triphosphate): Depletes GTP, interferes with viral mRNA synthesis → stops the virus from making proteins
36
what else is Ribavirin used to treat?
Hepatitis C Hantavirus
37
what are the adverse effects of Ribavirin?
Headache Rash Cough Fatigue
38
what is Palivizumab and what is it used for?
It is a monoclonal antibody that blocks the fusion protein on RSV for the prevention of RSV in high-risk infants
39
what are the adverse effects of Palivizumab?
More respiratory tract infections GI symptoms
40
who is the RSV vaccine recommended for?
adults >60 yrs old young children
41
what are the drugs for treatment of Chronic Hepatitis B?
Tenofovir and Entecavir
42
what are the MOA for Tenofovir and Entecavir?
they inhibit the HBV DNA polymerase at the reverse transcriptase (RT) domain * Tenofovir also works against HIV by blocking its reverse transcriptase
43
what are the adverse effects of Tenofovir and Entecavir?
Nausea Diarrhea Headache Fatigue Dizziness * Tenofovir can be nephrotoxic
44
why are Tenofovir and Entecavir the preferred drugs for long-term HBV suppression?
have low resistance rates
45
what are Interferons (alpha-2a, alpha-2b) used for the treatment of?
Chronic Hepatitis B and C Cancer: like malignant melanoma and lymphoma Laryngeal papillomatosis
46
what is the MOA for Interferons (alpha-2a, alpha-2b)?
Activates JAK kinases inside host cells → phosphorylates signal transducers → activating protein kinases which: ⬇️ Viral mRNA ⬇️ Protein synthesis (by reducing eIF-2 activity) ⬇️ tRNA availability
47
what are the adverse effects of Interferons (alpha-2a, alpha-2b)?
Flu-like symptoms ⬇️ White blood cells → immunosuppression Fatigue, headache Can trigger antibody development
48
what are the drugs for Chronic Hepatitis C treatment?
Ledipasvir Velpatasvir Sofosbuvir Dasabuvir Glecaprevir ** Ribavirin: add-on for genotype 3 w/cirrhosis
49
what is the MOA for Ledipasvir and Velpatasvir?
NS5A protein inhibitors which block viral replication and assembly
50
what is the MOA for Sofosbuvir and Dasabuvir?
NS5B RNA polymerase inhibitors which stop viral RNA replication
51
what is the MOA for Glecaprevir?
NS3/4A protease inhibitors which block processing of viral proteins
52
what are the adverse effects of chronic hepatitis C drugs?
Nausea, vomiting Diarrhea Headache Fatigue Rash
53
what are the drugs used for COVID-19 treatment?
Remdesivir – IV Nirmatrelvir + Ritonavir – oral
54
what is the MOA for Remdesivir?
Nucleotide prodrug that inhibits SARS-CoV-2 RNA-dependent RNA polymerase which blocks viral RNA replication
55
what are the adverse effects of Remdesivir?
Nausea, constipation Soreness at the injection site Elevated liver enzymes (transaminases) Allergic/hypersensitivity reactions
56
what is the MOA for Nirmatrelvir + Ritonavir (Oral)?
Nirmatrelvir blocks a key SARS-CoV-2 protease, reducing viral replication and Ritonavir slows breakdown of nirmatrelvir to increase its effect
57
what are the adverse effects of Nirmatrelvir + Ritonavir (Oral)?
Muscle pain (myalgias) Taste impairment (things taste weird) Increased blood pressure (BP) Diarrhea
58
what is the Gardasil vaccine?
recombinant vaccine that protects against multiple HPV types by producing neutralizing antibodies
59
what are the treatments for HPV warts?
Trichloroacetic acid Imiquimod (cream) Podofilox (gel)
60
what are the MOA for the HPV wart treatments?
- Trichloroacetic acid: destroys warts by chemical coagulation of proteins - Imiquimod (cream): immune modulator, stimulates production of interferon & other cytokines - Podofilox (gel): cytotoxic/antimitotic agent, arrests virus mitosis in metaphase
61
what is the HIV life cycle?
HIV attaches to the cell and enters → Reverse transcription → Integration into host DNA → HIV makes viral proteins → virus leaves the cell and matures
62
what is the PrEP (Pre-Exposure Prophylaxis) medication combination used for HIV treatment?
Tenofovir + Emtricitabine
63
what is the PEP (Post-Exposure Prophylaxis) medication combination used for HIV treatment?
Tenofovir & Emtricitabine AND Raltegravir or Dolutegravir or Bictegravir
64
what are the Nucleoside/Nucleotide RT Inhibitors (NRTIs) for HIV treatment?
Abacavir Emtricitabine Tenofovir Lamivudine Zidovudine
65
what are the Non-Nucleoside RT Inhibitors (NNRTIs) for HIV treatment?
Rilpivirine Efavirenz Nevirapine
66
what are the adverse effects for the Nucleoside/Nucleotide RT Inhibitors (NRTIs)?
GI issues bone marrow suppression peripheral neuropathy lactic acidosis hypersensitivity
67
what are the adverse effects for the Non-Nucleoside/Nucleotide RT Inhibitors (NNRTIs)?
Rash Hepatotoxicity **in general, less toxic than NRTIs
68
what are the Protease Inhibitors used for HIV treatment?
Atazanavir Darunavir Lopinavir/Ritonavir
69
how do Atazanavir, Darunavir and Lopinavir/Ritonavir work?
Competitively inhibit HIV protease, to inhibit formation of mature viral proteins
70
what are the adverse effects of Atazanavir, Darunavir and Lopinavir/Ritonavir?
GI issues hyperglycemia increase TGs - increase cholesterol - inhibition of P450
71
what are the Integrase Inhibitors used for HIV treatment?
Bictegravir Cabotegravir Dolutegravir
72
how do Bictegravir, Cabotegravir and Dolutegravir work?
Prevent incorporation of viral DNA into host chromosomal DNA to prevent replication
73
what are the adverse effects of Bictegravir, Cabotegravir and Dolutegravir?
GI issues headache increase in creatinine clearance
74
what are the entry inhibitors used for HIV treatment?
Maraviroc Enfuvirtide * Used mostly as alternatives in patients resistant to other treatments
75
what is the MOA for Maraviroc?
Blocks the CCR5 co-receptor on the surface of human immune cells which prevents HIV from attaching to and entering the cell
76
what is the MOA for Enfuvirtide?
Binds to gp41, a protein on the HIV surface which prevents fusion between the virus and the host cell membrane.
77
what are the adverse effects for Maraviroc?
cough fever upper resp. infection musculoskeletal symptoms
78
what are the adverse effects for Enfuvirtide?
redness, itching, bruising at injection site

Inflamm Final (13 decks)

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