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Antiviral Drugs Flashcards

1
Q

Why class of drug is Acyclovir?

A

prodrug

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2
Q

What is the clinical use of Acyclovir?

A

HSV-1, HSV-2, VZV

note: high doses used for VZV

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3
Q

In regards to the MOA for Acyclovir, Acyclo-GMP is converted to acyclo-GTP. What two things does this do?

A
  1. inhibits DNA poly

2. blocks viral replication

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4
Q

What is the mechanism of drug resistance for Acyclovir?

A

mutation of thymidine kinase - leads to selection of viruses that do not activate acyclovir

mutation and selection of viral DNA poly that are not inhibited by acyclo-GTP

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5
Q

What are the adverse effects of Acyclovir?

A

Topical - burning sensation
Oral - nausea, diarrhea, headache
IV - reversible renal damage

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6
Q

What are the contraindications of using Acyclovir?

A

avoid IV-coadministration with other nephrotoxic drugs

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7
Q

What are two other drugs similar to Acyclovir?

A

valacylcovir and famiciclovir

note: both prodrugs

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8
Q

What class of drug is Ganciclovir?

A

prodrug

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9
Q

What is the clinical indication for Trifluridine? (prodrug)

A

ocular HSV 1 or 2

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10
Q

What is the MOA of trifluridine?

A

inhibits viral DNA synthesis

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11
Q

What are the adverse effects of trifluridine?

A

burning and stinging, edema of the eyelid

note: (ophthalmic solution)

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12
Q

What is the indication for Vidarabine?

A

acute keratoconjunctivitis and recurrent epithelial keratitis caused by HSV 1 or 2

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13
Q

What is the MOA of Vidarabine?

A

inhibits DNA synthesis

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14
Q

What are the adverse effects of Vidarabine?

A

burning and stinging

note: ophthalmic solution

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15
Q

What are the adverse effects of Ganciclovir?

A

granulocytopenia and thrombocytopenia

note: should not be used during pregnancy

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16
Q

What is the indication for Ganciclovir?

A

CMV, Transplant prophylaxis

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17
Q

What is the MOA for Ganciclovir?

A

monophosphate is phosphorylated by cellular kinases in CMV infected cells -> triphosphate = inhibits DNA poly and viral replication is blocked

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18
Q

In regards to drug interactions, coadministration of Ganciclovir with ____ exacerbates granulocytopenia and thrombocytopenia

A

zidovudine

note: contraindication

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19
Q

In regards to drug interactions, coadministration of Ganciclovir with ___ can reduce granulocytopenia

A

G-CSF

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20
Q

This is a prodrug of Ganciclovir. If taken orally, it’s just as effective for CMV as IV Ganciclovir

A

Valganciclovir

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21
Q

This drug is approved for only one indication - CMV retinitis in AIDS patients. Its MOA is converting to codifier diphosphate in cells and inhibiting viral DNA poly.

22
Q

This drug is approved for CMV retinitis in AIDS patients and acyclovir resistant HSV in IC patients. It is nephrotoxic.

23
Q

What is the clinical use for Fomivirsen?

A

CMV retinitis in patients that do not respond to another drug

24
Q

What class of drug is Fomivirsen?

25
What is the MOA of Fomivirsen?
binds mRNA and inhibits transcriptional unit of CMV
26
What are the adverse effects of Fomivirsen?
ocular inflammation
27
In regards to drug interaction with Fomivirsen, how is ocular inflammation suppressed?
glucocorticoids
28
Lamivudine, Adefovir, Entecavir and Tenofovir (nucleoside analogs) are all drugs for what?
Hep B
29
Sofosbuvir, Ribavarin, and Interferon alpha, Simeprevir, and Ledipasvir are all drugs for what?
Hep C
30
What is the MOA of the nucleoside analogs used to treat Hep B?
inhibit Hep B reverse transcriptase
31
Lamivudine is not a cure for Hep B. What two things does it do in treating Hep B?
suppresses viral replication and reduces liver inflammation
32
Pegylated Interferon is used for Hep C. What is its MOA?
binds to receptors on infected cells, reduces viral entry, synthesis of viral mRNA and inhibits viral assembly
33
What are the adverse effects of P Interferon?
flu like symptoms, depression
34
Ribavirn is used to treat Hep C. What are the adverse effects that are associated with it?
hemolytic anemia
35
Simeprevir used for Hep C. What is its MOA?
NS3/4A protease inhibitor
36
Sofosbuvir is a polymerase inhibitor prodrug used to treat Hep C. What is its MOA?
triphosphate derivative mimics the natural uridine nucleotide and is incorporated by the HCV RNA poly - results in chain termination
37
Ledipasvir is used to treat Hep C. What is its MOA?
NS5A protein inhibitor
38
In regards to guidelines from AASLD/IDSA on treatment of HCV genotype 1A, give the correct combination dosage of Ledipasvir/Sofobuvir
daily fixed dose for 12 weeks ledipasvir: 90mg sofosbuvir: 400mg
39
In regards to guidelines from AASLD/IDSA on treatment of HCV genotype 1A, give the correct combination dosage of Sofosbuvir/Simeprevir
Daily fixed dose with or without weight-based RBV for 12 weeks or 24 weeks simeprevir: 150mg sofosbuvir: 400mg
40
There are two classes of drugs for influenza: adamntanes and neuroaminadse inhibitors. Give the drugs (2 each) that fall under these classes.
adamantanes: amantadine, Rimantadine neuroaminidase inhibitors: oseltamivir, zanamivir
41
What type of Influenza are amantadine and rimantadine used for?
influenza A note: drugs are not active against influenza B
42
What is the MOA of amantadine and rimantadine?
inhibit viral proton channels note: these proton channels are needed for uncoating the virus so it can be replicated in the cell
43
Amantadine and Rimantadine are both taken orally. What are their adverse effects?
CNS - dizziness, nervousness, insomnia
44
What type of influenza are the neuraminidase inhibitors, Oseltamivir and Zanamivir used for?
influenza A and B
45
When must the neuroaminidase inhibitors be taken in order to improve outcome?
within 2 days of symptoms
46
What is the MOA of the neuraminidase inhibitors?
catalyzes cleavage of sialic acid residues on host cell and influenza virus - these residues are required for release of viral progeny from host cells
47
This drug is for emergency use only. It is currently the only IV option for treating swine flue (H1N1)
peramivir
48
In regards to RSV infection, what two drugs are approved? although neither is very effective
Ribavirin (inhaled) | Palivizumab (antibody)
49
How often is the Rabies vaccine given to workers (due to post-exposure prophylaxis)?
every 2 years
50
Amantadine and Rimantadine are used prophylactically in what settings?
scientists, nursing homes, not in agriculture - resistance could arise

Pharmacology (7 decks)

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