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POD Exam #2 > Antiviral Medications > Flashcards

Antiviral Medications Flashcards

1
Q

Acyclovir: MOA

A
  • Phosphorylated by THYMIDINE KINASE
  • Inhibits viral DNA polymerase
  • Chain termination
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2
Q

CSF penetration by Acyclovir

A

Good

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3
Q

Placenta/Umbilical cord penetration (acyclovir)

A

Good

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4
Q

What formulation(s) is Acyclovir available in

A
  • Oral
  • IV
  • Topical
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5
Q

2 side effects mainly associated with IV Acyclovir treatment

A
  • Phlebitis

- Renal Toxicity

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6
Q

Common side effect associated with virtually ALL antiviral medications that are taken orally or IV

A

CNS (headache, hallucinations, seizure)

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7
Q

Main use of acyclovir (3)

A
  • Herpes Simplex
  • Herpes Zoster
  • Viral Encephalitis (IV formulation)
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8
Q

What is acyclovir in-effective in treating

A

Cytomegalovirus

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9
Q

What drug is the “prodrug” of acyclovir

A

Valacyclovir

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10
Q

Valacyclovir: MOA

A

Same as acyclovir, it must go through first pass metabolism however, to become active

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11
Q

What formulation (s) is valacyclovir available in

A

Oral only

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12
Q

2 reasons why valacyclovir is used instead of acyclovir

A
  1. Less frequent dosing

2. Good option if IV access is unavailable or refused by patient

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13
Q

Main use of valacyclovir (2)

A
  • Herpes Simplex

- Herpes Zoster

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14
Q

Ganciclovir: MOA

A

Same as acyclovir

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15
Q

Main use of Ganciclovir (2)

A
  • CMV infections

- Epstein-Barr

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16
Q

T/F Ganciclovir can be used to treat Herpes Simplex and Herpes Zoster

A

True, works very well. It’s main use however is with CMV and Epstein-Barr infections

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17
Q

Main adverse effect of ganciclovir useage

A

Bone marrow suppression (neutropenia-main) (thrombocytopenia)

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18
Q

What drug is the “prodrug” of ganciclovir

A

Valganciclovir

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19
Q

Main use of Valganciclovir

A

CMV (retinitis and prophylaxis)

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20
Q

Penciclovir: MOA

A

Same as acyclovir

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21
Q

What formulation (s) is penciclovir available in

A

Topical cream only (1%)

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22
Q

Main use of penciclovir (1)

A

-Herpes Simplex (cold sores)

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23
Q

What is the “prodrug” of penciclovir

A

Famciclovir

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24
Q

T/F Famciclovir is only available topically

A

False, oral versions are available

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25
Q

Main use of famciclovir (2)

A
  • Herpes Simplex

- Herpes Zoster

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26
Q

Cidofovir: MOA

A

-Interacts with DNA polymerase

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27
Q

T/F cidofovir requires thymidine kinase

A

False

28
Q

Main adverse reaction associated with cidofovir useage

A

Nephrotoxicity!!!

29
Q

What must cidofovir be administered with due to its major side effect of nephrotoxicity (2)

A
  1. Saline

2. Probenecid

30
Q

How often is cidofovir administered

A

Once weekly

31
Q

Main use of cidofovir (1)

A

-CMV retinitis in AIDS patients

32
Q

What drug should be tried first before cidofovir or foscarnet should be used

A

Ganciclovir

33
Q

Foscarnet: MOA

A

-Competes for pyrophosphate site on DNA polymerase

34
Q

T/F foscarnet requires thymidine kinase

A

False

35
Q

Main adverse reaction associated with foscarnet usage

A

Nephrotoxicity!!!

36
Q

Main use of foscarnet (2)

A
  • CMV retinitis in AIDS patients

- Acyclovir resistant Herpes Simplex

37
Q

Interferon: MOA

A

Unknown

38
Q

What is an interferon

A
  • Produced by cells in the body that have been infected by a virus
  • IMMUNE SYSTEM IN A BOTTLE
39
Q

Adverse reactions to using interferons

A

Similar to actually obtaining a viral infection, influenza-like reaction

40
Q

2 types of interferons

A

Type I and Type II

41
Q

Main use of interferons

A

Treatment for Hep. B and C infections

42
Q

Type I interferons

A

alpha: Hep B and C
beta: Multiple sclerosis

43
Q

Type II interferons

A

gamma: Not commercially available

44
Q

Lamivudine: MOA

A

-Inhibits reverse transcriptase

45
Q

What drug is lamivudine generally combined with

A

Interferons

46
Q

Main adverse reaction with lamivudine use

A

BLACK BOX WARNING

  • Lactic acidosis
  • Severe Hepatomegaly
47
Q

Main use of lamivudine (2)

A
  • Hep B virus

- HIV

48
Q

Ribavirin: MOA

A

Unknown

49
Q

Adverse effect with ribavirin use (1)

A

Anemia

50
Q

Main use of ribavirin (2)

A
  • RSV infections (bronchitis/pneumonia)

- Hep C

51
Q

What age group is ribavirin commonly used in

A

Children

52
Q

Imiquimod: MOA

A

Induces local interferon and TNF-alpha release

53
Q

What disease is imiquimod used to treat

A

Genital warts

54
Q

Amantadine/Rimantidine: MOA

A

Prevents virus from entering susceptible cells

55
Q

Which drug (amantadine/rimantidine) has worse CNS effects

A

Amantadine

56
Q

Which drug (amantadine/rimantidine) requires renal adjustment

A

Amantadine

57
Q

Main use of amantadine/rimantidine (2)

A
  • Prophylaxis of Influenza A

- Treatment of Influenza A

58
Q

To treat influenza A, when does amantadine/rimantidine therapy need to be started

A

Within first 48 hours of symptoms

59
Q

What other disease has amantadine been shown to treat, however it is not routinely used

A

Parkinsonism

60
Q

Osteltamivir/Zanamivir: MOA

A

-Inhibits influenza virus neuroaminidase

61
Q

Neuroaminidase is required for

A

Release of the virus from infected cells

62
Q

Osteltamivir adverse reaction (1)

A

GI discomfort (nausea, vomiting, abdomen pain)

63
Q

Zanamivir adverse reaction (2)

A
  • Wheezing

- Bronchospasm

64
Q

What does zanamivir have respiratory system associated reaction?

A

It is an oral inhalation of dry powder

65
Q

Use of zanamivir is discouraged in what 2 diseases?

A
  • COPD

- Asthma

66
Q

Osteltamivir/Zanamivir is used to treat what

A

Influenza A and B

67
Q

How helpful are osteltamivir/zanamivir?

A

Not very, they reduce Flu symptoms 1 day

POD Exam #2 (9 decks)

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