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pharmacology 3 > Antiviral medications > Flashcards

Antiviral medications Flashcards

1
Q

what is the adult and child dose for oseltamivir?

what is the dose for prophylaxis?

A

adult dose 75mg BID for 5 days
child dose 30-75mg BID for 5 days
prophylaxis 75mg OD for 10 days

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2
Q

oseltamivir and zanamivir belong to which class

A

neuraminidase inhibitors

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3
Q

what is the MOA of oseltamivir and zanamivir

A

Oseltamivir and Zanamivir inhibit neuraminidase and virions accumulate at the internal infected cell surface without release

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4
Q

neuraminidase inhibitors are effective against ifluenza A, B and C. t/f

A

false. only infleunza A and B

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5
Q

oseltamivir and zanamivir are taken orally. t/f

A

false. oseltamivir is taken orally, zanamivir is inhaled or taken intranasally

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6
Q

zanamivir should be avoided in patients with _________.

A

COPD and asthma

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7
Q

what is the adverse effect associated with oseltamivir

A

GIT discomfort

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8
Q

name the drugs which act by inhibiting viral uncoating

A

amantadine and rimantadine

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9
Q

what is the MOA of amantadine/rimantadine

A

These drugs block the viral membrane matrix protein M2 which is required for fusion of the viral membrane with the cell membrane to form the endosome.
They also interfere with the release of new virions.

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10
Q

amantadine/rimantadine are effective only against ________.

A

infleunza A virus

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11
Q

amantadine/rimantadine arnot effective against vaccines why?

A

used to supplement vaccinations

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12
Q

which drug crosses the BBB

a. amantadine
b. rimantadine

A

a. amantadine

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13
Q

amantadine is teratogenic but rimantadine is not. t/f

A

false. both are teratogenic

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14
Q

amantadine causes CNS problems whereas rimantadine does not. t/f

A

true because rimantadine does not cross the BBB

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15
Q

both amantadine/rimantadine cause GI problems. t/f

A

true

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16
Q

what are the therapeutic indiations of ribavirin

A

Effective against many RNA and DNA viruses
Used in severe respiratory syncytial virus bronchiolitis in infants and children
Used in combination with interferon for chronic hepatitis C

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17
Q

MOA of ribavirin

A

Ribavirin prevents mRNA capping and blocking of RNA polymerase

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18
Q

is ribavirin effective against all viruses?

A

no, ribavirin is only effective against viruses that synthesize mRNA

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19
Q

adverse effects of ribavirin

A

Dose dependent anemia in oral and parenteral use.
Elevated Bilirubin
Teratogenicity

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20
Q

ribavirin has good CNS penetration. t/f

A

false. it has poor CNS penetration.

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21
Q

what are the 2 drug combinations for hepatitis A and B

A

Hepatitis B – Interferon or Lamivudine

Hepatitis C – Interferon + Ribavirin

22
Q

what is an interferon. where is it used.

A

This is a naturally occurring glycoprotein that is synthesized by recombinant DNA technology
Utilized in management of Hepatitis B and C

23
Q

MOA of interferon

A

IFN bind to ganglioside receptors on host cell membranes. They induce the production of enzymes that inhibit the translation of viral mRNA into viral proteins so halting viral replication.

24
Q

what is the IFN half life

A

2-4 hrs

25
Q

IFN is administered orally only. t/f

A

false. Administered Scut or IV but not orally.

26
Q

what are the drug interactions of IFN

A

Potentiate bone marrow depression of other drugs such as Zidovudine

27
Q

MOA of lamivudine

A

Cytosine analog (phosphorylated by host cell enzymes to the active form) that inhibits HBV DNA polymerase and HIV reverse transcriptase

28
Q

uses of lamivudine

A

Used for Hepatitis B infections

Used for HIV infections in combination with other drugs.

29
Q

lamivudine requires dose adjustment in renal failure. t/f

A

true

30
Q

uses of acyclovir

A 
HSV-1
HSV-2
Varicella-zoster virus (VZV)
Epstein-Barr Virus
DOC in HSV encephalitis
Commonly used for genital herpes infections
31
Q

MOA of acyclovir

A

Acyclovir is a guanosine analog that is phosphorylated by viral thymidine kinase enzyme
It is further di and tri phosphorylated by the host cells and competes with dGTP for viral DNA polymerase.
It becomes incorporated into the viral DNA causing premature DNA chain termination.
Irreversible binding of acyclovir to viral DNA polymerase inactivates the enzyme

32
Q

acyclovir does not cross the BBB. t/f

A

false. it crosses the BBB

33
Q

Valacyclovir side effects

A

Gi disturbances, thromcytopenic purpura

34
Q

Foscarnet MOA

A

Reversibly inhibits viral DNA and RNA polymerases thereby inhibiting chain elongation.

35
Q

foscarnet uses

A

Used for CMV retinitis and acyclovir-resistant HSV and Herpes zoster infections

36
Q

ganicyclovir MOA

A

Acyclovir analog that inhibits DNA polymerase and is incorporated into DNA to decrease chain elongation

37
Q

ganicyclovir uses

A

Used for CMV retinitis and CMV prophylaxis in transplant patients

38
Q

MOA NRTIs

A

They are analogs of nucleosides or nucleotides lacking the 3’-OH group
Once they enter cells they are converted to triphosphate form by enzymes
Competes with equivalent host cell triphosphate substrates for DNA synthesis by viral reverse transcriptase.

39
Q

name a drug used in prophylaxis of HIV for pregnant and lactating females and infants.

A

zidovudine, azidothymidine

40
Q

AZT Adverse effects

A

GIT disturbances
Bone marrow depression – Blood disorders (anemia and neutropenia)
CNS – Insomnia, Dizziness, Headaches

41
Q

moa lamivudine

A

It terminates synthesis of viral DNA by inhibition of reverse transcriptase of both HIV and HBV

42
Q

name a drug for HIV ttt that does not affect mitochondrial DNA synthesis or bone marrow cells

A

lamivudine

43
Q

MOA NNRTIs

A

Highly selective noncompetitive inhibitors of HIV-1 reverse transcriptase enzyme
They bind to reverse transcriptase enzyme leading to conformational changes and enzyme inhibition.
Do not require activation by cellular enzymes

44
Q

treatment with ________ leads to _________ in CD$+ cells and ________ in viral load

A

efavirenz, increase, decrease

45
Q

absorption of efavirenz decreases with fatty meals. t/f

A

false. increases

46
Q

half life of efavirenz

A

t1/2 = 40 hours (once daily dosing)

47
Q

efavirenz is teratogenic. t/f

A

true

48
Q

MOA of indinavir/ nelfinavir

A

They inhibit HIV aspartyl protease enzyme.
This enzyme is responsible for cleavage of the viral polyprotein into essential enzymes and structural proteins
This prevents maturation of viral particles
Protease does not occur in host – useful target for selective intervention

49
Q

indinavir/ nelfinavir are ___________ inhibitors.

A

HIV Protease Inhibitors

50
Q

Buffalo Hump due to accumulation of fat at the base of the neck is due to…?

A

indinavir/ nelfinavir

pharmacology 3 (9 decks)

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