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First Aid > Antiviral Therapy > Flashcards

Antiviral Therapy Flashcards

1
Q

Zanamivir, oseltamivir mech

A

inhibit influenza neuraminidase : decrease the release of progeny virus

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2
Q

Zanamivir, oseltamivir clinical use

A

Treatment and prevention of both influenza A and B

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3
Q

Ribavirin Mech

A

Inhibits synthesis of guanine nucleotides by competitively inhibiting inosine monophosphate DH

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4
Q

clinical use of Ribavirin

A

RSV, Chronic Hep C

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5
Q

Ribavirin toxicity/SE

A

Hemolytic anemia. Severe teratogen.

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6
Q

Acyclovir, famciclovir, valacyclovir mech

A

Monophosphorylated by HSV/VZV thymidine kinase and not phosphorylated in uninfected cells: few adverse effects. Guanosine analog. Triphosphate analog. Triphosphate formed by cellular enzymes. Preferentially inhibits viral DNA polymerase chain termination

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7
Q

Acyclovir, famciclovir, valacyclovir clinical use

A

HSV and VZV; HSV-induced mucocutaneous and genital lesions as well as for encephalitis. Prophylaxis in immunocompromised patients. No effect on latent forms of HSV and VZV.

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8
Q

Acyclovir, famciclovir, valacyclovir have weak activity against what virus?

A

EBV

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9
Q

Acyclovir, famciclovir, valacyclovir has NO activity against what virus?

A

CMV

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10
Q

What is a prodrug of acyclovir? what is its advantage?

A

Valacyclovir; better bioavailability!

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11
Q

What is the treatment for herpes zoster?

A

Famciclovir! (I took this, wasn’t a hug fam of zoster haha)

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12
Q

Acyclovir, famciclovir, valacyclovir Toxicity

A

Obstructive crystalline nephropathy and acute renal failure if not adequately hydreated

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13
Q

What is the mech of resistance to acyclovir, famciclovir, valacyclovir?

A

Mutate viral thymidine kinase

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14
Q

Ganciclovir mech

A

5’-monophosphate formed by a CMV viral kinase. Guanosine analog. Triphosphate formed by cellular kinases. Preferentially inhibits viral DNA polymerase.

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15
Q

Ganciclovir Clinical use

A

CMV, especially in immunocompromised patients. Valganciclovir, a prodrug of ganciclovir, has better oral bioavailability

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16
Q

Ganciclovir Toxicity

A

Leukopenia, neutropenia, thrombocytopenia, renal toxicity. More toxic to host enzymes than acyclovir

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17
Q

What is the mech of resistance to Ganciclovir?

A

Mutated CMV DNA polymerase or lack of viral kinase

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18
Q

Foscarnet mech

A

Viral DNA polymerase inhibitor that binds to the pyrophosphate-binding site of the enzyme. Does not require activation by viral kinase.

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19
Q

What is the mneumonic for foscarnet?

A

Foscarnet = pyrofosphate analog

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20
Q

Foscarnet (2) clinical uses?

A

1) CMV retinitis in immunocompromised patietns when ganciclovir FAILS; 2) acyclovir-resistant HSV

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21
Q

Foscarnet toxicity?

A

Nephrotoxicty

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22
Q

What is the mech of resistance to Foscarnet?

A

Mutated DNA polymerase

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23
Q

Cidofovir mech

A

Preferentially inhibits viral DNA pol. Does not require phosphorylation by viral kinase.

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24
Q

What is the clinical use of Cidofovir?

A

CMV retinitis in immunocompromised patients; acyclovir-resistant HSV.

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25
Q

Does Cidofovir have a long or short half life?

A

long

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26
Q

When is HAART initiated?

A

when patients present with AIDS defining illness, low CD4 counts (

27
Q

What is the HAART regimen?

A

2 nucleoside reverse transcriptase inhibitors (NRTIs) + 1 non-nucleoside reverse transcriptase inhibitor (NNRTI) OR 1 protease inhibitor or 1 integrase inhibitor

28
Q

What are the Protease inhibitors? stating the suffix is good fucking enough

A

Atazanavir, Darunavir, Fosamprenavir, Indinavir, Lopinavir, Ritonavir, Saquinavir

29
Q

Mech of protease inhibitors

A

Assembly of virions depends on HIV-1 protease (pol gene), which cleaves the polypeptide products of HIV mRNA into their functional parts. Thus, protease inhibitors prevent maturation of new viruses.

30
Q

Which protease effects metabolism of other drugs? how?

A

Ritonavir can boost other drug concentrations by inhibiting CYP-450.

31
Q

Navir tease a protease

A

haha

32
Q

Protease inhibitor Toxicity

A

Hyperglycemia, GI intolerance (nausea, diarrhea), lipodystrophy. Nephropathy.

33
Q

What protease can cause hematuria?

A

Indinavir

34
Q

What are the Nucleoside Reverse transcription inhibitors?

A

Abacavir, Didanosine, Emtricitabine, Lamivudine, Stavudine, Tenofovir, Zidovudine (ZDV, formerly AZT)

35
Q

What is the mech of NRTIs?

A

Competively inhibit nucleotide binding to reverse transcriptae and terminate the DNA chain (lack a 3’OH group). The nucleosides need to be phosphorylated to be active

36
Q

Which NRTI is actually a nucleotide?

A

Tenofovir

37
Q

Which NRTI is used for general prophylaxis and during pregnancy to decrease the risk of fetal transmission?

A

ZDV

38
Q

Toxicity of NRTI’s

A

Bone marrow suppression (can be reversed with granulocyte colony-stimulating factor and erythropoietin, peripheral neuropathy, lactic acidosis (nucleosides), rash (non-nucleosides), anemia (ZDV), pancreatitis (didanosine).

39
Q

NNRTIs

A

Efavirenz, Nevirapine, Delavirdine

40
Q

Efavirenz, Nevirapine, Delavirdine mech

A

Bind to reverse transcriptae at site different from NRTIs. Do no require phosphorylation to be active or compete with nucleotides.

41
Q

Efavirenz Nevirapine, Delavirdine SE/Toxicity profile

A

Rash and hepatotoxicty are common to all NNRTIs. Vivid dreams and CNS symptoms are common with efavirenz. Delavirdine and efavirenz are contraindicated in pregnancy

42
Q

What is the integrase inhibitor?

A

Raltegravir

43
Q

Raltegravir mech

A

Inhibits HIv genome integration into host cell chromosome by reversibly inhibiting HIV integrae

44
Q

Raltegravir SE/toxicity

A

Hypercholestrolemia

45
Q

What are the fusion inhibitors?

A

Enfuvirtide, Marviroc

46
Q

Enfuvirtide mech

A

binds gp41, inhibiting viral entry

47
Q

Maraviroc mech

A

Binds CCR-5 on surface of T cells/monocytes, inhibiting interaction with gp120

48
Q

Skin reaction at injection site is a SE of which drug?

A

Enfuvirtide

49
Q

What are interferons?

A

Glycoproteins normally synthesize by virus-infected cells

50
Q

What is the mech of interferons?

A

antivrial and antitumoral properties

51
Q

IFN-alpha clinical usage?

A

Chronic Hep B & Hep C, Kaposi Sarcoma, Hairy cell leukemia, condyloma acuminatum, renal cell carcinoma, malignant melanoma

52
Q

IFN-beta

A

multiple sclerosis

53
Q

IFN-gamma

A

Chronic granulomatous disease

54
Q

Interferon toxicity

A

Neutropenia, myopathy

55
Q

Antibiotics to avoid in pregnancy + adverse effect?

A

The following are examples…..

56
Q

Sulfonamides

A

Kernicterus

57
Q

Aminoglycosides

A

Ototoxicty

58
Q

Fluoroquinolones

A

Cartilage damage

59
Q

Clarithromycin

A

Embryotoxic

60
Q

Tetracyclines

A

Discolored teeth, inhibition of bone growth

61
Q

ribavirin

A

Teratogenic

62
Q

Griseofulvin

A

Teratogenic

63
Q

Chloramphenicol

A

Gray Baby

First Aid (33 decks)

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