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Pharmacology > Antiviral Drugs > Flashcards

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.

A

Cidofovir

22
Q

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

A

Foscarnet

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?

A

antisense

25
Q

What is the MOA of Fomivirsen?

A

binds mRNA and inhibits transcriptional unit of CMV

26
Q

What are the adverse effects of Fomivirsen?

A

ocular inflammation

27
Q

In regards to drug interaction with Fomivirsen, how is ocular inflammation suppressed?

A

glucocorticoids

28
Q

Lamivudine, Adefovir, Entecavir and Tenofovir (nucleoside analogs) are all drugs for what?

A

Hep B

29
Q

Sofosbuvir, Ribavarin, and Interferon alpha, Simeprevir, and Ledipasvir are all drugs for what?

A

Hep C

30
Q

What is the MOA of the nucleoside analogs used to treat Hep B?

A

inhibit Hep B reverse transcriptase

31
Q

Lamivudine is not a cure for Hep B. What two things does it do in treating Hep B?

A

suppresses viral replication and reduces liver inflammation

32
Q

Pegylated Interferon is used for Hep C. What is its MOA?

A

binds to receptors on infected cells, reduces viral entry, synthesis of viral mRNA and inhibits viral assembly

33
Q

What are the adverse effects of P Interferon?

A

flu like symptoms, depression

34
Q

Ribavirn is used to treat Hep C. What are the adverse effects that are associated with it?

A

hemolytic anemia

35
Q

Simeprevir used for Hep C. What is its MOA?

A

NS3/4A protease inhibitor

36
Q

Sofosbuvir is a polymerase inhibitor prodrug used to treat Hep C. What is its MOA?

A

triphosphate derivative mimics the natural uridine nucleotide and is incorporated by the HCV RNA poly - results in chain termination

37
Q

Ledipasvir is used to treat Hep C. What is its MOA?

A

NS5A protein inhibitor

38
Q

In regards to guidelines from AASLD/IDSA on treatment of HCV genotype 1A, give the correct combination dosage of Ledipasvir/Sofobuvir

A

daily fixed dose for 12 weeks

ledipasvir: 90mg
sofosbuvir: 400mg

39
Q

In regards to guidelines from AASLD/IDSA on treatment of HCV genotype 1A, give the correct combination dosage of Sofosbuvir/Simeprevir

A

Daily fixed dose with or without weight-based RBV for 12 weeks or 24 weeks

simeprevir: 150mg
sofosbuvir: 400mg

40
Q

There are two classes of drugs for influenza: adamntanes and neuroaminadse inhibitors. Give the drugs (2 each) that fall under these classes.

A

adamantanes: amantadine, Rimantadine

neuroaminidase inhibitors: oseltamivir, zanamivir

41
Q

What type of Influenza are amantadine and rimantadine used for?

A

influenza A

note: drugs are not active against influenza B

42
Q

What is the MOA of amantadine and rimantadine?

A

inhibit viral proton channels

note: these proton channels are needed for uncoating the virus so it can be replicated in the cell

43
Q

Amantadine and Rimantadine are both taken orally. What are their adverse effects?

A

CNS - dizziness, nervousness, insomnia

44
Q

What type of influenza are the neuraminidase inhibitors, Oseltamivir and Zanamivir used for?

A

influenza A and B

45
Q

When must the neuroaminidase inhibitors be taken in order to improve outcome?

A

within 2 days of symptoms

46
Q

What is the MOA of the neuraminidase inhibitors?

A

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
Q

This drug is for emergency use only. It is currently the only IV option for treating swine flue (H1N1)

A

peramivir

48
Q

In regards to RSV infection, what two drugs are approved? although neither is very effective

A

Ribavirin (inhaled)

Palivizumab (antibody)

49
Q

How often is the Rabies vaccine given to workers (due to post-exposure prophylaxis)?

A

every 2 years

50
Q

Amantadine and Rimantadine are used prophylactically in what settings?

A

scientists, nursing homes, not in agriculture - resistance could arise

Pharmacology (7 decks)

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