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MEDICINAL ORGANIC CHEMISTRY > ANTIVIRALS > Flashcards

ANTIVIRALS Flashcards

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1
Q

4 Common Problems on Antivirals

A
  1. Resistance
  2. Ineffective (non-replicating virus)
  3. Limited spectrum
  4. -Static

RILS

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2
Q

Enumerate the viral process.

A
  1. Attachment
  2. Entry
  3. Release
  4. Replication
  5. Assembly
  6. Release

AERRAR

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3
Q

CHEMOPROPHYLAXIS INFLUENZA

For influenza A + Parkinson’s disease

A

Amantadine
(Symmetrel)

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4
Q

CHEMOPROPHYLAXIS INFLUENZA

Adverse effect of Amantadine (Symmetrel)

A

Livedo Reticularis

Others: CNS anticholinergic effects - Anxiety, Insomnia, Seizures

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5
Q

CHEMOPROPHYLAXIS INFLUENZA

MOA of amantadine

A
  1. Viral uncoating inhibition
  2. Viral assembly (Hemagglutinin processing)
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6
Q

CHEMOPROPHYLAXIS INFLUENZA

Tricyclic amine compounds

A

Amantadine + Rimantadine

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7
Q

CHEMOPROPHYLAXIS INFLUENZA

For influenza A at low concentrations

A

Amantadine + Rimantadine

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8
Q

CHEMOPROPHYLAXIS INFLUENZA

Methylated amantadine but 4-10 times more active and cause GI problems

A

Rimantadine

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9
Q

CHEMOPROPHYLAXIS INFLUENZA

Rimantadine causes ____ problems, while amantadine causes ____ effects.

A
  1. GI
  2. Anti-cholinergic
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10
Q

NEURAMINIDASE INHIBITORS

Neuraminidase inhibitors are active against ____.

A

Influenza A and B

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11
Q

NEURAMINIDASE INHIBITORS

Adverse effect of oseltamivir

A

Nausea & Vomiting

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12
Q

NEURAMINIDASE INHIBITORS

Adverse effect of zanamivir

A

Bronchospasms

C/I: COPD and Asthma

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13
Q

NEURAMINIDASE INHIBITORS

Neuraminidase inhibitors are ____ analogues.

A

Sialic acid

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14
Q

NEURAMINIDASE INHIBITORS

MOA of oseltamivir and zanamivir

A

Prevents the release and spread of new virions

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15
Q

NUCLEOSIDE ANALOGUES

Trifluridine

Identify the base.

A

Thymine

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16
Q

NUCLEOSIDE ANALOGUES

Idoxuridine

Identify the base.

A

Thymine

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17
Q

NUCLEOSIDE ANALOGUES

MOA of nucleoside analogs

A

Inhibiting viral replication

Act as antimetabolite

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18
Q

NUCLEOSIDE ANALOGUES

Vidarabine

Identify the base.

A

Adenosine

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19
Q

NUCLEOSIDE ANALOGUES

Acyclovir

Identify the base.

A

Guanosine

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20
Q

NUCLEOSIDE ANALOGUES

Valacyclovir

Identify the base.

A

Guanosine

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21
Q

NUCLEOSIDE ANALOGUES

Famciclovir

Identify the base.

A

Guanosine

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22
Q

NUCLEOSIDE ANALOGUES

Penciclovir

Identify the base.

A

Guanosine

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23
Q

NUCLEOSIDE ANALOGUES

Ganciclovir

Identify the base.

A

Guanosine

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24
Q

NUCLEOSIDE ANALOGUES

Cidofovir

Identify the base.

A

Cytosine

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25
Q

NUCLEOSIDE ANALOGUES

Ribavirin

Identify the base.

A

Guanosine

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26
Q

NUCLEOSIDE ANALOGUES

MOA of trifluridine and idoxuridine

A
  1. Act as substrate
  2. Viral DNA polymerase inhibition
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27
Q

NUCLEOSIDE ANALOGUES

Non-selective tx for herpes simplex keratitis

A

Idoxuridine

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28
Q

NUCLEOSIDE ANALOGUES

Tx for HSV (1 & 2) keratoconjunctivitis & recurrent epithelial keratitis

A

Trifluridine

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29
Q

NUCLEOSIDE ANALOGUES

2’ epimer of natural adenosine

A

Vidarabine
(ara-A)

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30
Q

NUCLEOSIDE ANALOGUES

Vidarabine source

A

Streptomyces antibioticus

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31
Q

NUCLEOSIDE ANALOGUES

Alternative to Idoxuridine as 3% ointment for HSV keratitis

A

Vidarabine

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32
Q

NUCLEOSIDE ANALOGUES

MOA of cytarabine

A

Blocks Deoxycytidine -> Replication inhibition

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33
Q

NUCLEOSIDE ANALOGUES

Drug of choice for Herpes simplex virus (HSV)

A

Cytarabine

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34
Q

NUCLEOSIDE ANALOGUES

Anti-cancer for burkitt lymphoma and myeloid & lymphatic leukemia

A

Cytarabine

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35
Q

NUCLEOSIDE ANALOGUES

A Trisodium phosphonoformate - inorganic pyrophosphate analog

Replaces the phosphate group

A

Foscarnet

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36
Q

NUCLEOSIDE ANALOGUES

MOA of foscarnet

A

Viral DNA polymerase inhibition (Non-competitive)

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37
Q

NUCLEOSIDE ANALOGUES

Prototype of anti-herpetic drug

A

Acyclovir

38
Q

NUCLEOSIDE ANALOGUES

MOA of acyclovir

A

Viral DNA polymerase inhibition

39
Q

NUCLEOSIDE ANALOGUES

Prodrug of acyclovir with better bioavailability

A

Valacyclovir

40
Q

NUCLEOSIDE ANALOGUES

Hydrolyzed to Penciclovir and has the greatest bioavailability

A

Famciclovir

41
Q

NUCLEOSIDE ANALOGUES

Used only topically whereas famciclovir can be administered orally

A

Penciclovir

42
Q

NUCLEOSIDE ANALOGUES

Drug of choice for Cytomegalovirus (CMV) retinitis

A

Ganciclovir

43
Q

NUCLEOSIDE ANALOGUES

Tx of herpes zoster (shingles) for immunocompromised patients

A

Valacyclovir

44
Q

NUCLEOSIDE ANALOGUES

Analogue of acyclovir with an additional hydroxymethyl group on the acyl side chain

A

Ganciclovir

45
Q

NUCLEOSIDE ANALOGUES

Topical tx of recurrent herpes labialis (cold sores)

A

Famciclovir/Penciclovir

46
Q

NUCLEOSIDE ANALOGUES

Drug of choice for Varicella zoster and chicken pox

A

Acyclovir and valacyclovir

47
Q

NUCLEOSIDE ANALOGUES

Tx of CMV retinitis in AIDS patients

A

Cidofovir

48
Q

NUCLEOSIDE ANALOGUES

2nd line drug for the tx of CMV retinitis in AIDS patients

1st line: Cidofovir

A

Foscarnet

49
Q

NUCLEOSIDE ANALOGUES

Adverse effects of Ribavirin

A
  1. Anemia
  2. Jaundice
50
Q

NUCLEOSIDE ANALOGUES

Drug of choice for RSV bronchiolitis, Pneumonia in hospitalized children, and Lassa fever

A

Ribavirin

51
Q

NUCLEOSIDE ANALOGUES

MOA of ribavirin

A

Interfere with viral transcription

52
Q

NUCLEOSIDE ANALOGUES

Phosphonic acid derivative that does not require phosphorylation

A

Cidofovir

53
Q

REVERSE TRANSCRIPTASE INHIBITORS (NRTIs)

Reverse transcriptase converts viral RNA into a ____, ready for integration into the host chromosome

A

double-stranded DNA

54
Q

NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTIs)

It has high affinity for HIV RT than for human DNA polymerase

A

Zidovudine (AZT)

55
Q

NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTIs)

Zidovudine (AZT) + ____ = Delayed AZT-resistant strains

A

Alpha Interferon

56
Q

NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTIs)

Zidovudine (AZT) can be combined with ____ to overcome bone marrow toxicity.

3 drugs

A
  1. Foscarnet
  2. Zalcitabine (ddC)
  3. Didanosine (ddI)
57
Q

NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTIs)

Symptomatic HIV + Pneumocystis carinii pneumonia (PCP)

A

Zidovudine (AZT)

58
Q

NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTIs)

for Zidovudine (AZT) intolerant HIV infection

A

Didanosine (ddI)

59
Q

NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTIs)

Zidovudine
(AZT)

Nucleoside analog

A

Thymidine

60
Q

NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTIs)

Stavudine
(D4T)

Nucleoside analog

A

Thymidine

61
Q

NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTIs)

Didanosine
(ddI)

Nucleoside analog

A

Guanosine

62
Q

NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTIs)

Lamivudine
(3TC)

Nucleoside analog

A

Cytidine

63
Q

NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTIs)

Zalcitabine
(ddC)

Nucleoside analog

A

Cytosine

64
Q

NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTIs)

Tenofovir

Nucleoside analog

A

Adenine

65
Q

NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTIs)

Zalcitabine (ddC) is combined with ____ for the tx of advance HIV infections.

A

Zidovudine
(AZT)

ZZ

66
Q

NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTIs)

Acid stable and well absorbed PO

A

Stavudine
(D4T)

67
Q

NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTIs)

Substitution of sulfur atom in place of a methylene group at the 3’ of the ribose ring

A

Lamivudine
(3CT)

68
Q

NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTIs)

____ + Zidovudine (AZT) = increase CD4+ count

A

Lamivudine
(3CT)

69
Q

NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTIs)

HIV 1 + Hepatitis B

A

Tenofovir

70
Q

MOA of pleconaril

A

Insert into pockets -> Interfere with virus + cell receptors

71
Q

It targets a broad spectrum of small RNA viruses (picornaviruses)

A

Pleconaril

72
Q

ANTI-RETROVIRALS (ART)

It refers to the multidrug regimen for HIV infection

A

Highly Active Anti-Retroviral Therapy
(HAART)

73
Q

ANTI-RETROVIRALS (ART)

5 drug classes used in HAART

A
  1. Protease inhibitors
  2. Entry inhibitors
  3. NRTIs
  4. Integrase inhibitors
  5. NNRTIs

PENIN

74
Q

NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NNRTIs)

MOA of NNRTIs

A
  1. HIC-1 inhibition
  2. Enzyme distortion
75
Q

NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NNRTIs)

NNRTIs do not require bioactivation because they do not have ____.

A

Nucleosides

76
Q

NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NNRTIs)

MOA of nevirapine (Viramune)

A
  1. CYP450 -> Hydroxylated metabolites (inactive)
  2. Hepatic recycling -> no DNA polymerase action
77
Q

NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NNRTIs)

____ is an NNRTI readily absorbed after oral administration due to its cyclopropyl.

A

Nevirapine
(Viramune)

78
Q

NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NNRTIs)

Pregnancy category of nevirapine (Viramune)

A

C

79
Q

NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NNRTIs)

The risk of ____ during nevirapine (Viramune) therapy is greatest in the first 6 weeks.

Other AE: Rashes, NV

A

Hepatitis

80
Q

NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NNRTIs)

____ must be used with at least two additional antiretrovirals for HIV-1

due to 98-99% protein bounding

A
  1. Delavirdine (Rescriptor)
  2. Efavirenz (Sustiva)

MOA: same as nevirapine (Viramune)

81
Q

NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NNRTIs)

Most common adverse effects of Efavirenz (Sustiva)

A
  1. CNS changes
  2. Rashes
  3. Hepatotoxicity
82
Q

NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NNRTIs)

NNRTI rashes can be severe and lead to ____ syndrome

A

Stevens-Johnson

83
Q

HIV PROTEASE INHIBITORS

Enzyme that cleaves gag-pro propeptides to yield active enzymes that function in the maturation & propagation of new virus

A

HIV Protease

84
Q

HIV PROTEASE INHIBITORS

HIV protease inhibitors can cause ____ and ____.

ADRs

A
  1. Dyslipidemia
  2. Hyperglycemia
85
Q

HIV ENTRY INHIBITORS

This is also known as compound T20

A

Pentafuside
Enfuvirtide

86
Q

HIV ENTRY INHIBITORS

This inhibits the formation of the fusion component conformation of GP41

A

Pentafuside
Enfuvirtide

87
Q

CHEMOKINE RECEPTOR BINDERS

1st compound identified as a CXCR4-specific inhibitor but not CCR5

A

Compound AMD-3100

88
Q

CHEMOKINE RECEPTOR BINDERS

Exhibits high affinity for CCR5 coreceptors

A

Compound TAK-779

89
Q

CHEMOKINE RECEPTOR BINDERS

MOA of chemokine receptor binders

A

Prevents attachment to CCXR4 and CCR5 on the CD4’s surface

90
Q

HAART

Foscarnet + Ganciclovir

Indication

A

HSV1 and 2

91
Q

HAART

Trifluridine (TFT) / Acyclovir + Interferon

Indication

A

Herpetic keratitis

MEDICINAL ORGANIC CHEMISTRY (17 decks)

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