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Pharmacology I Exam 3 > Antiviral Drugs > Flashcards

Antiviral Drugs Flashcards

1
Q

How is Acyclovir/Valacyclovir administered?

A

Oral, topical, IV

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2
Q

What is the MOA for Acyclovir/Valacyclovir?

A
  • Nucleotide analogue
  • Requires phosphorylation by viral thymidine kinase
  • Inhibits DNA synthesis
  • Concentrated in viral-infected cells
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3
Q

What are the uses of Acyclovir/Valacyclovir?

A

DOC:
VZV (Chicken pox/Shingles)

SAFE IN PREGNANCY

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4
Q

What are toxicities of Acyclovir/Valacyclovir?

A
  • N/V, HA

- Nephrotoxicity (high doses); need to hydrate

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5
Q

How does resistance develop to Acyclovir/Valacyclovir?

A

Resistance develops due to decrease in viral thymidine kinase

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6
Q

What is the MOA for Docosanol (Abreva)?

A

Inhibits viral fusion to host cell membrane so that the virus cannot enter cell

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7
Q

What are the uses of Docosanol (Abreva)?

A

OTC for HSV (cold sores)

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8
Q

How is Ganciclovir/Valganciclovir administered?

A

Oral, IV, ocular implant

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9
Q

What is the MOA for Ganciclovir/Valganciclovir?

A
  • Nucleoside analogue
  • Activated by viral kinases
  • Inhibits DNA polymerase
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10
Q

What are the uses for Ganciclovir/Valganciclovir?

A

DOC:
CMV
CMV retinitis
CMV + Herpes

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11
Q

What are toxicities of Ganciclovir/Valganciclovir?

A
  • Teratogenic!
  • Myelosuppresion: leukopenia
  • CNS: HA, confusion, seizures
  • Nausea, fever, rash
  • Hepatotoxicity
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12
Q

What are contraindications to Ganciclovir/Valganciclovir?

A

Pregnancy

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13
Q

How is Foscarnet administered?

A

IV

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14
Q

What is the MOA of Foscarnet?

A

Directly inhibits DNA & RNA polymerase, reverse transcriptase

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15
Q

What are the uses of Foscarnet?

A

DOC:
CMV encephalitis
(+ ganciclovir)

CMV retinitis
(if ganciclovir resistance)

HSV
(if acyclovir/ganciclovir resistant)

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16
Q

What are toxicities of Foscarnet?

A

Renal toxicity (renal elimination) – adjust dose and hydrate

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17
Q

What is the MOA for Cidofovir?

A
  • Nucleoside analogue

- Inhibits viral DNA polymerase

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18
Q

What are the uses of Cidofovir?

A 
CMV retinitis (IV)
(if ganciclovir resistance)

HSV (IV or topical)
(if acyclovir/ganciclovir resistant)

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19
Q

What are toxicities of Cidofovir?

A

Renal toxicity (renal elimination) – adjust dose and hydrate

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20
Q

What is the MOA for Oseltamivir (Tamiflu) and Zanamivir (Relenza)?

A

Neuraminidase inhibitors – block release of virus

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21
Q

What are the uses of Oseltamivir (Tamiflu) and Zanamivir (Relenza)?

A

DOC:

Influenza A and B (start within 48-72 hours)

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22
Q

How is Oseltamivir (Tamiflu) administered and who is it approved for?

A

Orally for those over 1 year old

23
Q

How is Zanamivir (Relenza) administered and who is it approved for?

A

Nasal or oral inhaler for those over 7 years old

24
Q

What are toxicities of Zanamivir (Relenza)?

A
  • May worsen respiratory function in COPD

- Bronchospasms in asthmatics

25
Q

What are toxicities of Oseltamivir (Tamiflu)?

A

N/V (take with food)

26
Q

In what population should you avoid prescribing Zanamivir (Relenza)?

A

Not recommended in those with airway disease

27
Q

What is the MOA for Baloxavir Marboxil (Xofluza)?

A

Inhibits DNA synthesis via mRNA

28
Q

How is Baloxavir Marboxil (Xofluza) administered and who is it approved for?

A

Orally in single dose for those over 12 years old

29
Q

What are the uses of Baloxavir Marboxil (Xofluza)?

A

Influenza A and B (start within 48-72 hours)

30
Q

How is Ribavirin administered?

A

Oral, IV, aerosol

31
Q

What is the MOA for Ribavirin?

A
  • Nucleoside analogue
  • Phosphorylated by host enzymes
  • Inhibits RNA polymerase and synthesis of GTP
32
Q

What are the uses of Ribavirin?

A

DOC:

RSV (aerosol)

33
Q

What are the toxicities of Ribavirin?

A 
Oral: 
- Hemolytic anemia (dose dependent)
Aerosol: 
- Respiratory depression, cardiac arrest, hypotension
IV: 
- Psychiatric (SI, depression)

Teratogenic! (Category X drug)

34
Q

What is a contraindication o Ribavirin?

A

Women in general (do not conceive for at least 6 months after exposure to drug)

35
Q

What is the MOA of Tenofovir?

A
  • Nucleoside analogue

- Inhibits HBV DNA polymerase

36
Q

What are the uses of Tenofovir?

A

DOC:

Hepatitis B

37
Q

What is the MOA for Entecavir?

A
  • Nucleoside analogue

- Inhibits HBV DNA polymerase

38
Q

What are the uses of Entecavir?

A

2nd DOC:

Hepatitis B

39
Q

What is the MOA for Lamivudine?

A
  • Nucleoside analogue

- Inhibits HBV DNA polymerase

40
Q

What are the uses of Lamivudine?

A

Hepatitis B

41
Q

What is the MOA for Harvoni?

A
  • Nucleoside analogue

- Inhibits viral NS5B RNA polymerase, blocking replication of HCV and causing termination

42
Q

What is the MOA for Epclusa?

A

Inhibits HCV NS5A protein which may prevent replication

43
Q

What are the uses for Harvoni and Epclusa?

A

DOC:

Hepatitis C

44
Q

What are the toxicities of Harvoni and Epclusa?

A

Fatigue, irritability, HA

45
Q

What is the DOC for VZV (Chicken pox/Shingles)?

A

Acyclovir/Valacyclovir

46
Q

What is the DOC for CMV?

A

Ganciclovir/

Valganciclovir

47
Q

What is the DOC for CMV encephalitis?

A

Foscarnet + Ganciclovir

48
Q

What is the DOC for CMV retinitis?

A

Ganciclovir/

Valganciclovir

49
Q

What are other drug options if there is CMV retinitis resistance to Ganciclovir?

A

Foscarnet OR Cidofovir

50
Q

What is the DOC for CMV + Herpes?

A

Ganciclovir/

Valganciclovir

51
Q

What is the DOC for Influenza A and B?

A

Oseltamivir (Tamiflu) and Zanamivir (Relenza)

52
Q

What is the DOC for RSV?

A

Ribavirin

53
Q

What are the top drug choices for Hepatitis B?

A

DOC:
Tenofovir

2nd DOC:
Entecavir

54
Q

What is the DOC for Hepatitis C?

A

Harvoni OR Epclusa

Pharmacology I Exam 3 (8 decks)

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