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Pharmacology > AntiViral Drugs > Flashcards

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
Q

Zanamivir MOA

A

same as oseltamivir but administered by inhalation=>very little resistance

26
Q

Zanamivir indications

A

Children 7 years and older

27
Q

Zanamivir Adverse

A

Cough, bronchospasm, temporary decrease in pulmonary function=>do not give to people w/ pre-existing pulmonary disease

28
Q

Peramivir

A

Same as zamivir/ oseltamivir, but delivered IV

29
Q

Peramivir Indications

A

Acute, uncomplicated influenza in pts who have had symptoms for 48 hours max

30
Q

Peramivir Adverse

A

Gi, rash, Steven Johnson syndrome, rare neurological issues

31
Q

Amantadine and Rimantadine MOA

A

Tricyclic amines, inhibits the Influenza A M2 protein

32
Q

Amantadine and Rimantadine Resistance

A

Amino acid subs in M2=>becoming more common

33
Q

Amantadine and Rimantadine Indications

A

Susceptible influenza A virus within first 48 hrs of symptoms

34
Q

Amantadine and Rimantadine adverse

A

Nausea, anorexia, mild neurological symptoms

35
Q

Respiratory Syncytial Virus (RSV)

A

Common Cold Virus

Most common cause of bronchiolitis and pneumonia in children under 1 year

36
Q

RSV Tx

A

Ribavirin for premature infants, immunocompromised, and pts w/ chronic lung or congenital heart disease

37
Q

Ribavirin MOA

A

Guanosine analogue, phosphorylated by adenosine kinase, interferes with guanosine triphosphate
Inhibits viral mRNA capping

38
Q

Ribavirin Pharmkinetics

A

Aerosol route for RSV

Oral combo therapy for Hep C

39
Q

Ribavirin Adverse

A

Hemolytic anemia, depression, fatigue, rash, cough

40
Q

Ribavirin Contraindications

A

Pregnancy, anemia, ischemic vascular disease, severe renal disease

41
Q

Which genotype of Hep C virus is least responsive to treatment

A

Type 1 Hep C

42
Q

Hep C virus disease/signs

A

Inflammation of the liver=> jaundice, diarrhea, alcholic stool, increased ALT and AST

43
Q

Paritaprevir MOA

A

HCV Protease inhibitor=> inhibits NS3/4A protease

44
Q

Paritaprevir Adverse

A

Asthenia, fatigue, nausea, insomnia

45
Q

Paritaprevir Resistance and Indications

A

NS3 gene substitutions

Chronic HCV infections=>combination therapy w/ ombitasvir and ritonavir

46
Q

Simeprevir MOA

A

HCV protease inhibitor, inhbits NS3/4A protease. Used w/ sofosbuvir or ribavirin and pegylated INF

47
Q

Simeprevir Adverse

A

Rash, pruritis, dyspena, nausea, myalgia

48
Q

Simeprivir Resistance and Indications

A

NS3 Q80 K polymorphism=>must be screened for

Chronic HCV

49
Q

Ledipasivr MOA

A

Nucleotide analogue of HCV NS5A inhibitor

50
Q

Ledipasvir Adverse

A

Diarrhea, fatigue, headache, hyperbilirubinemia

51
Q

Lidepasvir Resistance and Indications

A

NS5A gene substitutions

Chronic HCV infections

52
Q

Ombitasvir MOA

A

HCV NS5A inhibitor, used in combo w/ paritaprevir and ritonavir

53
Q

Ombitasivr Adverse

A

Asthenia, fatigue, nausea, insomnia

54
Q

Sofosbuvir MOA

A

Nucleotide analog prodrug, incorporated into RNA=>premature chain termination

55
Q

Sofosbuvir Adverse

A

Anemia, fatigue, headache, insomnia, nausea

56
Q

Sofosbuvir Resistance

A

Very likely=>not recommended for monotherapy

57
Q

Dasabuvir MOA

A

Non-nucleoside inhibitor of RNA-dependent RNA polymerase=> causes viral life cycle to stop prematurely

58
Q

Dasabuvir Combo therapy

A

Used w/ ombitasvir, paritaprevir, and ritonavir

59
Q

Dasabuvir Adverse and Resistance

A

Fatigue, asthenia, insomnia

Very likely=>not recommended for monotherapy

Pharmacology (11 decks)

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