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AntiViral Drugs Flashcards

1
Q

Acyclovir MOA

A

Nucleoside analogue=>requires phosphorylation by viral thymidine kinase, compeitive inhibitor of viral DNA polymerase

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2
Q

Acyclovir pharmkinetics

A

15-20% oral bioavailability

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3
Q

Acyclovir resistance

A

Mutation of thymidine kinase

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4
Q

Acyclovir Indications

A

Oral route for genital herpes and varicella zoster

IV for severe mucocutaneous disease, neonate infections,

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5
Q

Acyclovir adverse

A

nausea/headace/diarrhea

Reversible crystalline nephrotoxicity w/ neurological effects=>fix with rehydration

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6
Q

Valacyclovir

A

Prodrug of acyclovir=>metabolized into acyclovir in the liver

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7
Q

Valacyclovir Indications

A

Primary and recurrent genital herpes
Varicella in older kids/adults
Zoster
Orolabial herpes

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8
Q

Foscarnet MOA

A

Analogue of pyrophospate
BLocks the catalytic cycle=>**Does NOT require prior phosphorylation
Only delivered IV, rare resistance

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9
Q

Foscarnet indications

A

HSV and VSV that are resistant to acyclovir

CMV

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10
Q

Foscarnet adverse

A

REnal impairment

Blood chemistry changes

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11
Q

Ganciclovir MOA

A

Guanosine analogue=>requires viral kinase to become activated=>competitive inhibitor of viral DNA polymerase

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12
Q

Ganciclovir resistance

A

Mutaiton in the UL97 gene=>cannot be phosporylated

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13
Q

Ganciclovir indications

A

IV administration for CMV infections

Intraocular injection/implant for CMV retintitis

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14
Q

Ganciclovir adverse

A

Myelosuppression, bone marrow/CNS toxicity

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15
Q

Valganciclovir MOA

A

Prodrug of ganciclovir=> metabolized into ganciclovir by liver/intestines. Higher oral biovailability

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16
Q

Valganciclovir Indications

A

CMV retinitis (AIDS), prevention of CMV disease in pts w/ heart/kidney transplants

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17
Q

Trifluridine MOA

A

Fluorinated nucleoside=>Compeititive inhibitor of thymidine

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18
Q

Trifluridine Indications

A

Low selectivity=>not good for systemic disease

Ocular administration to treat keratoconjuctivitis secondary to HSV-1/2

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19
Q

Time frame for antiviral drugs given to treat influenza

A

Must be given within 48 hours to impact disease process

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20
Q

Most common complication with influenza virus

A

Pneumonia

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21
Q

Oseltamivir MOA

A

Sialic acid analogue/prodrug=> Binds to active site of neuraminidase to inhibit function and inhibit spread of progeny virions

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22
Q

Oseltamivir Resistance

A

Point mutaitons in hemagglutinin or neruaminidase genes

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23
Q

Oseltamivir Indicatiosn

A

Approved for children 1 year and older, effective against influenza A and B
Must be given within first 48 hrs

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24
Q

Oseltamivir Adverse

A

Nause/vomiting/abd pain/headache/fatigue/diarrhea

25
Zanamivir MOA
same as oseltamivir but administered by inhalation=>very little resistance
26
Zanamivir indications
Children 7 years and older
27
Zanamivir Adverse
Cough, bronchospasm, temporary decrease in pulmonary function=>do not give to people w/ pre-existing pulmonary disease
28
Peramivir
Same as zamivir/ oseltamivir, but delivered IV
29
Peramivir Indications
Acute, uncomplicated influenza in pts who have had symptoms for 48 hours max
30
Peramivir Adverse
Gi, rash, Steven Johnson syndrome, rare neurological issues
31
Amantadine and Rimantadine MOA
Tricyclic amines, inhibits the Influenza A M2 protein
32
Amantadine and Rimantadine Resistance
Amino acid subs in M2=>becoming more common
33
Amantadine and Rimantadine Indications
Susceptible influenza A virus within first 48 hrs of symptoms
34
Amantadine and Rimantadine adverse
Nausea, anorexia, mild neurological symptoms
35
Respiratory Syncytial Virus (RSV)
Common Cold Virus | Most common cause of bronchiolitis and pneumonia in children under 1 year
36
RSV Tx
Ribavirin for premature infants, immunocompromised, and pts w/ chronic lung or congenital heart disease
37
Ribavirin MOA
Guanosine analogue, phosphorylated by adenosine kinase, interferes with guanosine triphosphate Inhibits viral mRNA capping
38
Ribavirin Pharmkinetics
Aerosol route for RSV | Oral combo therapy for Hep C
39
Ribavirin Adverse
Hemolytic anemia, depression, fatigue, rash, cough
40
Ribavirin Contraindications
Pregnancy, anemia, ischemic vascular disease, severe renal disease
41
Which genotype of Hep C virus is least responsive to treatment
Type 1 Hep C
42
Hep C virus disease/signs
Inflammation of the liver=> jaundice, diarrhea, alcholic stool, increased ALT and AST
43
Paritaprevir MOA
HCV Protease inhibitor=> inhibits NS3/4A protease
44
Paritaprevir Adverse
Asthenia, fatigue, nausea, insomnia
45
Paritaprevir Resistance and Indications
NS3 gene substitutions | Chronic HCV infections=>combination therapy w/ ombitasvir and ritonavir
46
Simeprevir MOA
HCV protease inhibitor, inhbits NS3/4A protease. Used w/ sofosbuvir or ribavirin and pegylated INF
47
Simeprevir Adverse
Rash, pruritis, dyspena, nausea, myalgia
48
Simeprivir Resistance and Indications
NS3 Q80 K polymorphism=>must be screened for | Chronic HCV
49
Ledipasivr MOA
Nucleotide analogue of HCV NS5A inhibitor
50
Ledipasvir Adverse
Diarrhea, fatigue, headache, hyperbilirubinemia
51
Lidepasvir Resistance and Indications
NS5A gene substitutions | Chronic HCV infections
52
Ombitasvir MOA
HCV NS5A inhibitor, used in combo w/ paritaprevir and ritonavir
53
Ombitasivr Adverse
Asthenia, fatigue, nausea, insomnia
54
Sofosbuvir MOA
Nucleotide analog prodrug, incorporated into RNA=>premature chain termination
55
Sofosbuvir Adverse
Anemia, fatigue, headache, insomnia, nausea
56
Sofosbuvir Resistance
Very likely=>not recommended for monotherapy
57
Dasabuvir MOA
Non-nucleoside inhibitor of RNA-dependent RNA polymerase=> causes viral life cycle to stop prematurely
58
Dasabuvir Combo therapy
Used w/ ombitasvir, paritaprevir, and ritonavir
59
Dasabuvir Adverse and Resistance
Fatigue, asthenia, insomnia | Very likely=>not recommended for monotherapy

Pharmacology (11 decks)

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