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IBI Test I > Antivirals > Flashcards

Antivirals Flashcards

1
Q

Anti-Influenza drugs

A

Oseltamivir, Zanamivir, Rimantadine

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2
Q

mechanism: oseltamivir, zanamivir

A

inhibit neuraminidase; inhibit viral progeny release

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3
Q

sialic acid analogs

A

oseltamivir, zanamivir

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4
Q

adverse effects: oseltamivir, zanamivir

A

GI upset

**zanamivir may exacerbate COPD/asthma

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5
Q

flu strain treated by oseltamivir and zanamivir

A

A and B

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6
Q

inhibitors of viral genome replication: HSV and VZV

A

acyclovir, valacyclovir

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7
Q

inhibitors of viral genome replication: CMV

A

ganciclovir, valganciclovir

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8
Q

Inhibitors of viral genome replication: HSV, VZV, CMV

A

cidofovir, foscarnet

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9
Q

Antihepatitis Virus

A

ribavirin
INF a

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10
Q

hepatitis B

A

lamivudine
tenofovir
adefovir
entecavir
telbivudine

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11
Q

hepatitis C

A

simeprevir
sofosbuvir
ledepasvir
daclatasvir
dasabuvir

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12
Q

Does acyclovir cure HSV/VZV infections?

A

no, mangement

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13
Q

mechanism: acyclovir, valacyclovir

A

nucleoside analog
guanine attached to acyclic moiety

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14
Q

acyclovir is activated by

A

thymidine kinase

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15
Q

ACV monophosphate is converted to

A

ACV triphosphate

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16
Q

resistance to acyclovir

A

mutation/loss of thymidine kinase

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17
Q

mechanism: ribavirin

A

inhibits guanine synthesis, mutates viral DNA

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18
Q

ribavirin is activated by

A

host kinases

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19
Q

ribavirin inhibits

A

RNA polymerase

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20
Q

Clinical Use: Ribavirin

A

Hep C, RSV (aerosol)

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21
Q

adverse effects: ribavirin

A

hemolytic anemia
teratogen
pruritis

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22
Q

resistance: ribavirin

A

genotype 1 HCV

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23
Q

administration: ribavirin

A

oral, inhalation

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24
Q

excretion: ribavirin

A

urine

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25
Q

adverse effects: acyclovir

A

crystalline nephropathy
renal failure with poor hydration

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26
Q

administration: acyclovir

A

oral, IV, topical

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27
Q

excretion: acyclovir

A

urine

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28
Q

prodrugs have higher

A

oral bioavailability

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29
Q

mechanism: ganciclovir

A

guanosine analog

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30
Q

initial phosphorylation of ganciclovir is done by

A

UL97

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31
Q

clinical use: ganciclovir

A

CMV first line

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32
Q

adverse effects: ganciclovir

A

bone marrow suppression
nephrotoxicity
CNS toxicity
teratogen

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33
Q

resistance: ganciclovir

A

mutated tyrosine kinase

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34
Q

administration: ganciclovir

A

IV, opthalmic

35
Q

excretion: ganciclovir

36
Q

why is ganciclovir more toxic?

A

better substrate for kinases= higher toxicity, less selectivity

37
Q

mechanism: foscarnet

A

nucleoside analog, viral DNA/RNA inhibitor

38
Q

foscarnet inhibits

39
Q

clinical use: foscarnet

A

CMV 2nd line
acyclocvir resistant HSV
broad spectrum for viral illnesses

40
Q

adverse effects: foscarnet

A

nephrotoxicity
electrolyte imbalance
seizures

41
Q

resistance: foscarnet

A

mutated DNA polymerase

42
Q

administration: foscarnet

43
Q

excretion: foscarnet

44
Q

mechanism: cidofovir

A

nucleotide analog, inhibits viral DNA polymerase

45
Q

clinical use: cidofovir

A

CMV, HSV (3rd line)

46
Q

adverse effects: cidofovir

A

nephrotoxicity

47
Q

administation: cidofovir

48
Q

excretion: cidofovir

49
Q

what can reduce the toxicity of cidofovir?

50
Q

mechanism: trifluridine

A

thymidine analogue, requires host kinases

51
Q

clinical use: trifluridine

A

HSV 1/2 Keratitis, CMV

52
Q

adverse effects: trifluridine

A

hypersensitivity

53
Q

administation: trifluridine

A

opthalmic, topical

54
Q

INF-a mechanism

A

cytokine, anti-viral state activates JAK/STAT

55
Q

clinical use: INF-a

A

chronic HBV/HCV, condyloma acuminatum, HHV-8, hairy cell leukemia, renal cell carcinoma, malignant melanoma

56
Q

INF-a adverse effects

A

neutropenia, myopathy, depression, flu-like symptoms

57
Q

administration INF-a

58
Q

excretion INF-a

59
Q

mechanism: lamivudine

A

cytosine analog, inhibits HIV RT and HBV polymerase

60
Q

clinical use: lamivudine

61
Q

adverse effects: lamivudine

A

headache, fever, nausea

62
Q

resistance: lamivudine

A

mutated polymerase

63
Q

mechanism: sofosbuvir

A

HCV RNA dependent RNA polymerase

64
Q

clinical use: sofosbuvir

A

HCV w/ ledipasvir

65
Q

adverse effects: sofosbuvir

A

headache, fever, nausea

66
Q

telaprevir mechanism

A

HCV protease inhibitor

67
Q

clinical use: telaprevir

A

HCV w/ peg-interferon, ribavirin

68
Q

adverse effects: telaprevir

A

rash, pruritis, fatigue, GI, anemia, CYP3A inhibition

69
Q

resistance: telaprevir

A

develops rapidly

70
Q

mechanism: simeprevir

A

HCV protease inhibitor

71
Q

clinical use: simeprevir

A

HCV w/ ribavirin, simeprevir, ledipasvir

72
Q

adverse effects: simeprevir

A

photosensitivity, rash

73
Q

rimantidine/amantadine mechanism

A

inhibits M2 protein, inhibits viral uncoating

74
Q

clinical use: rimantidine

A

Flu A PPX or treatment

75
Q

adverse effects: rimantadine

A

severe CNS, GI

76
Q

mechanism of resistance: rimantadine

A

mutated M2 protein, widespread resistance

77
Q

Ozeltamivir/zanamavir mechanism

A

NA inhibitor

78
Q

Ozeltamivir/zanamavir clinical use

A

flu A and B

79
Q

adverse effects oseltamivir

A

headache, GI

80
Q

zanamivir adverse effects

A

headache, sore throat, asthma ex.

81
Q

Ozeltamivir/zanamavir resistance

A

NA mutation

82
Q

administration Ozeltamivir

83
Q

administation zanamivir

IBI Test I (18 decks)

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