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POD Exam 2 > antiviral medications > Flashcards

antiviral medications Flashcards

1
Q

what are 5 major categories antiviral medications are used for in clinical treatment

A
  1. Herpes
  2. cytomegalovirus
  3. influenza
  4. respiratory syncytial virus
  5. HIV
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2
Q

in the virus life cycle, where does the antiviral drug try to inhibit the process

A
  1. attachment/entry to host cell
  2. inhibit transcription/translation
  3. interference of viral assembly
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3
Q

what type of virus has a different order of life cycle

A

retrovirus

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4
Q

Ion channel blocker drugs Amantadine and Rimantadine require what type of envirnment

A

acidic environment

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5
Q

what consists of the herpesvises viruses

A

chichenpox
shingles
oral and genital herpes

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6
Q

hepadnaviruses is what type of virus

A

hep B

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7
Q

cytomegalosvirus is commenly seen in what type of patients

A

transplant patients

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8
Q

respiratory syncytial virus occurs is who and what it is

A

pneumonia and bronchiolitis in children

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9
Q

what is the mechanism of action for Acyclovir

A
  • acyclovir is phosphorylated into monophostphate via thymidine kinase (HSV or VZV)
  • monophosphate to triphosphate via cellular enzymes
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10
Q

in Acyclovir, what does the triphosphate form do?

A

acts as a chain terminator

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11
Q

what is the bioavailability of Acyclovir

A

low

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12
Q

Acyclovir can go where in the body pretty well

A

CSF
placenta
umbilical cord

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13
Q

what is an adverse effect of acylcovir if given with high dose bolus and IV formulation

A

Reversible nephrotoxicity do to crystalline nephropathy

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14
Q

what is a side effect for Acyclovir

A

headaches
hallucinations
seizures

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15
Q

what is the prodrug for acyclovir

A

valacylovir

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16
Q

what is the bioavailablity for Valacyclovir

A

excellent

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17
Q

when is valacylovir converted to acyclovir

A

first pass intestinal and hepatic metabolism

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18
Q

what is valacylovir and acyclovir used to treat

A

Genital Herpes simple

Genital Herpes zoster

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19
Q

what is the drug of choice for Encephalistis

A

IV acyclovir

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20
Q

what does Valacylovir treat

A

Genital Herpes simple

Genital Herpes zoster

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21
Q

what is the difference between Valacylovir and Acylcovir in dosing

A

valacylovir is less frequent dosing

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22
Q

what is the prodrug choice for Ganciclovir

A

Valganciclovir

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23
Q

what is the mechanism of action for Ganciclovir

A

similar acyclovir

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24
Q

What is the bioavailability for ganciclovir

A

low

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25
Q

for CMV ( cytomegalovirus) what is the best drug choice, why?

A

Ganciclovir

- less accumulated of phosphorylated acyclovir present in CMV then Ganciclovir

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26
Q

what is the adverse effects of Ganciclovir

A

headache
behavior changes
n/v

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27
Q

what does Ganciclovir treat

A

CMV retinitis

CMV prophylaxis in transplant patients

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28
Q

Valganciclovir has what MOA

A

similar to acyclovir/ganciclovir

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29
Q

what is the bioavailability for valganciclovir

A

good

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30
Q

what does valganciclovir treat

A

CMV Retinitis

CMV prophalaxis

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31
Q

what is the prodrug for penciclovir

A

famciclovir

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32
Q

what is the MOA for penciclovir

A

similiar to acyclovir

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33
Q

how is pencicvlovir available in the US

A

topical cream only

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34
Q

what is an adverse effect of penciclovir

A

application site of irritation

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35
Q

what is a clinical use for penciclovir

A

herpes simplex ( cold sores)

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36
Q

what is the bioavailbilty of famciclovir

A

good

37
Q

how is famciclovir excreted

A

renal, requiring dose reductions

38
Q

what is the clinical use for famciclovir

A

herpes simples

herpes zoster

39
Q

what is the mechanism for docosanol

A

not similar to acyclovir MOA

40
Q

Docosanol treats what

A

oral herpes simplex

41
Q

Imiquimod treats

A

gential/perianal warts

42
Q

podofilox treats

A

genital/ parianal warts

43
Q

podophyllin treats

A

warts

44
Q

Cidofovir has what MOA

A

different from acyclovir and ganciclovir

-interacts with DNA polymerase

45
Q

what are adverse effects does Cidofovir have

A

nephrotoxicity

neutropnia

46
Q

why is Cidofovir a second tier drug

A

high nephrotoxicity

47
Q

When is Cidofovir used for

A

when ganciclovir fails to treat CMV retinitis

48
Q

in order to reduce Cidofovir nephrotoxicity what do you do

A
  • administer with normal Saline

- hydration

49
Q

in order to treat CMV with Cidofovr, how must it be administered? when must it be taken

A

with probenecid

-before/after/maintenance dose

50
Q

what is the mechanism of action for foscarnet

A

competes for pyrophosphate in viral DNA polymerase

51
Q

what is the adverse effects of foscarnet

A 
nephrotixicity 
n/v/d
seizures
anemia
EKG changes 
severe electrolyte imbalances
52
Q

in what tier is foscarnet used

A

second

53
Q

what is the clinical use for foscarnet

A
  • CMV retinits with AIDS patients

- when acyclovir is resistant to herpes simplex in immunocompromised patients

54
Q

what does immune system in a bottle refer to

A

interferons

55
Q

what are interferons

A

produced by body in response to virus infection

56
Q

what is the gold standard in treatment for certain types of Hep B

A

interferon therapy

57
Q

what are some symptoms for interferon therapy

A

sore, joint, pain

mock body’s natural reaction

58
Q

when children receive interferon therapy what is a common adverse effect

A

personality changes

59
Q

what is used after interferon therapy in order to improve pharmacokinetics

A

pegalated (polyethelene glycol)

60
Q

what are the different types of interferons

A

Type I: alpha and beta

Type II: gamma

61
Q

what is type I interferon alpha used for

A

hepB
condyloma acuminata
kaposi sarcoma

62
Q

what is type I interferon beta used for

A

multiple sclerosis

63
Q

what is Type II interferon gamma

A
  • normally produced by T cells

- not commercially made

64
Q

what is the mechanism of action for Lamivudine

A

inhibits reverse transcriptase

65
Q

what is the bioavailability for Lamivudine

A

good

66
Q

what is the adverse effect for Lamivudine

A

Black box warning: lactic acidosis and severe hepatomegaly

67
Q

what does Lamivudine treat

A
  • combo with interferons to treat hep B

- part of HIV treatment

68
Q

Ribavirin MOA

A

unknown

69
Q

which antiviral drug has good half life

A

Ribavirin

70
Q

what are adverse effects of Ribavirin

A

combo with interferons increases anemia, fatigue, depression

71
Q

what is Ribavirin used for

A

RSV bronchiolitis and pneumonia in hospitalized children

72
Q

Imiquimod treats what

A

topical treatment for condylomata acuminate ( warts)

73
Q

how well does Imiquimod treat warts

A

recurrence is common

74
Q

Amantadine is similar to what other drug

A

Rimantadine

75
Q

what is the mechanism of action for amantadine and rimantadine

A

prevents virus from entering host cell

76
Q

what adjustment is required for amantadine but not for rimantadine

A

renal adjustment

77
Q

Amantadine plays a role in what disease

A

5 tier drug for Parkinson’s

78
Q

both Amantidine and Rimantadine are used clinically for what

A

treat and prevent influenza A

79
Q

what are the adverse effects of amantidine and rimantadine

A

confusion, insomnia

more pronounced in amantidine

80
Q

How is osteltamivir given

A

tablet

81
Q

how is Zanamivir given, what does it cause

A

inhaler

cause wheezing/bronchospasm

82
Q

what is the mechanism of action for osteltamivir and zanamivir

A

inhibits neuroaminidase which is required for the release of virus from infected cell

83
Q

what is the clinical use for osteltamivir and zanamivir

A

influenza A and B

84
Q

amantadine and rimantadine need what type of environment to work

A

low pH

85
Q

what drugs are anti-herpetic

A

acyclovir, valacyclovir

penciclovir, famciclovir

86
Q

what drugs are anti-CMV

A

cidofovir
foscarent
granciclovir
valganciclovir

87
Q

what drugs are anti- influenza

A

amantadine
rimantadine
ostelmavir
zanamivir

88
Q

what drugs treat hepatitis B/C

A

interferons +/- ribavirin, lamivudine

POD Exam 2 (28 decks)

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