antiviral medications Flashcards by Bina Malapur

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

Herpes
cytomegalovirus
influenza
respiratory syncytial virus
HIV

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

attachment/entry to host cell
inhibit transcription/translation
interference of viral assembly

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what type of virus has a different order of life cycle

retrovirus

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

acidic environment

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what consists of the herpesvises viruses

chichenpox
shingles
oral and genital herpes

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hepadnaviruses is what type of virus

hep B

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cytomegalosvirus is commenly seen in what type of patients

transplant patients

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respiratory syncytial virus occurs is who and what it is

pneumonia and bronchiolitis in children

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what is the mechanism of action for Acyclovir

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

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in Acyclovir, what does the triphosphate form do?

acts as a chain terminator

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what is the bioavailability of Acyclovir

low

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Acyclovir can go where in the body pretty well

CSF
placenta
umbilical cord

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

Reversible nephrotoxicity do to crystalline nephropathy

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what is a side effect for Acyclovir

headaches
hallucinations
seizures

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what is the prodrug for acyclovir

valacylovir

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what is the bioavailablity for Valacyclovir

excellent

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when is valacylovir converted to acyclovir

first pass intestinal and hepatic metabolism

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what is valacylovir and acyclovir used to treat

Genital Herpes simple

Genital Herpes zoster

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what is the drug of choice for Encephalistis

IV acyclovir

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what does Valacylovir treat

Genital Herpes simple

Genital Herpes zoster

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what is the difference between Valacylovir and Acylcovir in dosing

valacylovir is less frequent dosing

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what is the prodrug choice for Ganciclovir

Valganciclovir

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what is the mechanism of action for Ganciclovir

similar acyclovir

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What is the bioavailability for ganciclovir

low

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

Ganciclovir | - less accumulated of phosphorylated acyclovir present in CMV then Ganciclovir

what is the adverse effects of Ganciclovir

headache behavior changes n/v

what does Ganciclovir treat

CMV retinitis | CMV prophylaxis in transplant patients

Valganciclovir has what MOA

similar to acyclovir/ganciclovir

what is the bioavailability for valganciclovir

good

what does valganciclovir treat

CMV Retinitis | CMV prophalaxis

what is the prodrug for penciclovir

famciclovir

what is the MOA for penciclovir

similiar to acyclovir

how is pencicvlovir available in the US

topical cream only

what is an adverse effect of penciclovir

application site of irritation

what is a clinical use for penciclovir

herpes simplex ( cold sores)

what is the bioavailbilty of famciclovir

good

how is famciclovir excreted

renal, requiring dose reductions

what is the clinical use for famciclovir

herpes simples | herpes zoster

what is the mechanism for docosanol

not similar to acyclovir MOA

Docosanol treats what

oral herpes simplex

Imiquimod treats

gential/perianal warts

podofilox treats

genital/ parianal warts

podophyllin treats

warts

Cidofovir has what MOA

different from acyclovir and ganciclovir | -interacts with DNA polymerase

what are adverse effects does Cidofovir have

nephrotoxicity | neutropnia

why is Cidofovir a second tier drug

high nephrotoxicity

When is Cidofovir used for

when ganciclovir fails to treat CMV retinitis

in order to reduce Cidofovir nephrotoxicity what do you do

- administer with normal Saline | - hydration

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

with probenecid | -before/after/maintenance dose

what is the mechanism of action for foscarnet

competes for pyrophosphate in viral DNA polymerase

what is the adverse effects of foscarnet

``` nephrotixicity n/v/d seizures anemia EKG changes severe electrolyte imbalances ```

in what tier is foscarnet used

second

what is the clinical use for foscarnet

- CMV retinits with AIDS patients | - when acyclovir is resistant to herpes simplex in immunocompromised patients

what does immune system in a bottle refer to

interferons

what are interferons

produced by body in response to virus infection

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

interferon therapy

what are some symptoms for interferon therapy

sore, joint, pain | mock body's natural reaction

when children receive interferon therapy what is a common adverse effect

personality changes

what is used after interferon therapy in order to improve pharmacokinetics

pegalated (polyethelene glycol)

what are the different types of interferons

Type I: alpha and beta | Type II: gamma

what is type I interferon alpha used for

hepB condyloma acuminata kaposi sarcoma

what is type I interferon beta used for

multiple sclerosis

what is Type II interferon gamma

- normally produced by T cells | - not commercially made

what is the mechanism of action for Lamivudine

inhibits reverse transcriptase

what is the bioavailability for Lamivudine

good

what is the adverse effect for Lamivudine

Black box warning: lactic acidosis and severe hepatomegaly

what does Lamivudine treat

- combo with interferons to treat hep B | - part of HIV treatment

Ribavirin MOA

unknown

which antiviral drug has good half life

Ribavirin

what are adverse effects of Ribavirin

combo with interferons increases anemia, fatigue, depression

what is Ribavirin used for

RSV bronchiolitis and pneumonia in hospitalized children

Imiquimod treats what

topical treatment for condylomata acuminate ( warts)

how well does Imiquimod treat warts

recurrence is common

Amantadine is similar to what other drug

Rimantadine

what is the mechanism of action for amantadine and rimantadine

prevents virus from entering host cell

what adjustment is required for amantadine but not for rimantadine

renal adjustment

Amantadine plays a role in what disease

5 tier drug for Parkinson's

both Amantidine and Rimantadine are used clinically for what

treat and prevent influenza A

what are the adverse effects of amantidine and rimantadine

confusion, insomnia | more pronounced in amantidine

How is osteltamivir given

tablet

how is Zanamivir given, what does it cause

inhaler | cause wheezing/bronchospasm

what is the mechanism of action for osteltamivir and zanamivir

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

what is the clinical use for osteltamivir and zanamivir

influenza A and B

amantadine and rimantadine need what type of environment to work

low pH

what drugs are anti-herpetic

acyclovir, valacyclovir | penciclovir, famciclovir

what drugs are anti-CMV

cidofovir foscarent granciclovir valganciclovir

what drugs are anti- influenza

amantadine rimantadine ostelmavir zanamivir

what drugs treat hepatitis B/C

interferons +/- ribavirin, lamivudine