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Pharm3- fixed > AntiViral-Table 1 > Flashcards

AntiViral-Table 1 Flashcards

1
Q

What are viruses hard to tx?

A
  • Effective treatment requires that the drug must enter the host cell
  • Most antivirals agents inhibit single steps in viral replication and are virustatic- need competent host immune system
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2
Q

What are the inhibitors of viral attachment (uncoating or release)?

A 
Docosanol
Amantadine
Rimantadine
Oseltamivir
Zanamivir
Peramivir
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3
Q

What are the inhibitors of viral attachment?

A

Amantadine and Rimantadine

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4
Q

What is the MOA of the inhibitors of viral attachment?

A

¨Bind viral protein M2 and inhibit viral uncoating

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5
Q

How are the inhibitors of viral attachment used?

A

for treatment and prophylaxis of influenza type A, no effect on type B-lack M2

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6
Q

Do the inhibitors of viral attachment have a wide or narrow therapeutic index? Why is this important to know?

A

Narrow therapeutic index
(therapeutic 0.5-0.8mcg/mL, CNS toxic >1-5 mcg/mL)
this is important bc of the cns toxic effects- seizure, coma, delirium

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7
Q

When is amantadine specifically used?

A

Parkinsons

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8
Q

How is amatadine excreted?

A

Majority Unchanged in the urine

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9
Q

How is RImantadine metabolized?

A

Liver

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10
Q

What are the neuroaminidase inhibitors?

A

Oseltamivir, Zanamivir, Peramivir

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11
Q

What is the MOA of the neuroaminidase inhibitors?

A

Selective inhibitors of viral neuraminidases which are essential for release of virus from the infected cell

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12
Q

What are the neuroaminidase inhibitors used for?

A

¨Treatment of influenza A and B, duration 5 days

can be effective prophylactically before or after exposure to influenza A/B

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13
Q

How is oseltamivir administered?

A

Orally

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14
Q

What are some ADRs of oseltamivir? How can you diminish these?

A

N/V, take with food

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15
Q

How is Zanamivir administered?

A

Intranasal or inhaled dry powder

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16
Q

What can be an ADR of Zanamivir? Which pts should you prescribe this with caution in?

A

produce bronchospasms

careful in patients with asthma or COPD

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17
Q

How is Peramivir administered?

A

IV

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18
Q

What is an ADR of Peramivir ?

A

Diarrhea

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19
Q

What drug inhibits attachement?

A

DOcosanol- prevents viral attachment to human cell

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20
Q

How is Docosanol administered?

A

OTC creamw

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21
Q

What is docosanol used for and when should it be started?

A

Oral/genital herpes

Begin tx within 12 hrs of prodromal symptoms or lesion onset

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22
Q

What are the drug categories that block DNA synthesis from viral DNA?

A

Guanosine analog and Cytosine Analog

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23
Q

What are the above drug groups active against?

A

Herpes family

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24
Q

What are the guanosine analogs?

A 
¨Acyclovir
¨Valacyclovir
¨Penciclovir
¨Famiciclovir
¨Ganciclovir
Valganciclovir
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25
Q

What are the cytosine analogs?

A

Cidfovir

26
Q

What is the mechanism of viral resistance in nAcyclovir, Valacyclovir, Penciclovir, Ganciclovir, Valganciclovir?

A

Phosphorylated by viral thymidine kinase

27
Q

What is the oral prodrug of acyclovir?

A

Valcyclovir

28
Q

What are acyclovir and valcyclovir used for?

A

-Treatment and Prophylaxis of:
Herpes simplex (type I and II) and zoster
Varicella zoster- treatment

29
Q

When do val/acyc need to be administered to a pt with varicella zoster?

A

w/I 24hrs of rash onset to decrease symptoms by day 1

30
Q

What is the DOC for HVS infections?

A

Val/acyc

31
Q

What pts is acyclovir used prophylactically in?

A

Seropositive pts undergoing immunosuppressive therapy- prevent mucocutaneous HSV infections

32
Q

When are penciclorvir and famciclovir used?

A

to treat Herpes Zoster, Herpes simplex type II, topical treatment of oral/labial herpes simplex virus

33
Q

How are ganciclovir and valganciclovir phosphorylated?

A

by viral protein kinase in cytomegalovirus and by viral thymidine kinase in herpes simplex virus then further phosphorylated by host enzymes

34
Q

What are ganciclovir and valganciclovir active against?

A

All herpes viruses

35
Q

What are ganciclovir and valganciclovir used to tx specifically?

A

CMV in immunocompromised pts

36
Q

What are some ADRs of ganciclovir and valganciclovir?

A

Neutropenia, thrombocytopenia, teratogenic

37
Q

What is vitasert?

A

an intraocular sustained release implant for CMV retinitis (ganciclovir and valganciclovir?)

38
Q

How is cidofovir phosphorylated?

A

by host enzymes- males this useful when viral thymidine kinase resistance has developed

39
Q

What is the spectrum of activity for cidofovir?

A

Broad spectrum: herpes and pox viruses, adenoviruses, papilloma viruses, and hepadenavirus

40
Q

What is cidofovir primarily used for?

A

treatment of cytomegalovirus in AIDS patients who are intolerant, relapsed, or nonresponsive to ganciclovir or foscarnet
AND
Acyclovir resistant mucocutaneous HSV infection

41
Q

What are the ADRs of cidofovir?

A

Neutropenia and nephrotoxicity

42
Q

What are the nucleotide analogs?

A

Adefovir and tenofovir

43
Q

What is adefovir used for?

A

treatment of chronic active infections HepB

44
Q

Does adefovir need to be phosphorylated?

A

this drug does NOT require phosphorylation

45
Q

How is tenofovir processed?

A

Hydrolysis then phosphorylation

46
Q

What is tenofovir used for?

A

HIV and Hep B tx

47
Q

What is foscarnet?

A

-an inorganic phosphate analog that acts by directly inhibiting DNA and RNA polymerases and reverse transcriptases- 100 x greater effect on viral vs human DNA polymerase

48
Q

Does foscarnet require phosphorylation?

A

Nope

49
Q

What is foscarnet active against?

A

all herpes viruses, influenza, and HIV

50
Q

What are the primary uses of foscarnet?

A

CMV infections, acyclovir resistant herpes simplex or varicella zoster

51
Q

How is foscarnet administered?

A

Infusion in large volume of fluid

52
Q

What are the ADRs of Foscarnet?

A

-Nephrotoxicity- dose limiting in 10-25% of patients

¨Increased risk with amphotericin B and aminoglycosides

53
Q

What is Ribavirin?

A

A purine nucleoside analog that is phosphorylated intracellularly by host cell enzymes

54
Q

What is ribavirin aerosol used to tx?

A

RSV

55
Q

What is ribavirin plus peginterferon used for?

A

Tx of Hep C

56
Q

What are interferons?

A

Immunomodulatory and antiviral drugs that are non-specific inhibitors of RNA and protein synthesis- basically it prevents translation of viral proteins

57
Q

What are the dose limiting toxicities of interferons?

A
  • Neutropenia and anemia

- Flu like syndrome”- fever, fatigue, myalgia

58
Q

Interferon A/B are produced by almost all cells in response to what?

A

Viral infection

59
Q

What produces interferon Gamma?

A

T-cells and NK cells in response to antigens and cytokines

60
Q

What is interferon A used for?

A

Chronic Hep C/B
Genital warts from papilloma virus
Hariy cell leukemia
Kaposis sarcoma

61
Q

What is interferon B used for?

A

Remitting MS

62
Q

What is interferon Y(gamma) used for?

A

Chronic granulomatous disease

Pharm3- fixed (12 decks)

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