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Antivirals Flashcards

1
Q

Classes of HIV drugs

A

NRTI
NNRTI
Protease inhibitors
INSTIs

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2
Q

MOA of NRTI

A

nucleoside analog inhibits reverse transcriptase which inhibits cDNA

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3
Q

NRTI HIV drugs

A

Tenofovir disoproxil fumarate
Tenofovir alafenamide
Emtricitabine
Abacavir
Lamivudine

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4
Q

Special consideration for Abacavir

A

HLA-B5701 allele

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5
Q

AE’s of HIV NRTI

A

bone marrow suppression
pancreatitis
peripheral neuropathy
hepatotoxicity
lactic acidosis
nephrotoxicity

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6
Q

NNRTI HIV drugs

A

“-vir-“

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7
Q

AE’s of HIV NNRTI

A

depression
hepatotoxicity
QTc prolongation
IRIS

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8
Q

HIV protease inhibitor drugs

A

“-navir”

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9
Q

MOA of NNRTI

A

bind to reverse transcriptase and inhibit cDNA

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10
Q

MOA of protease inhibitors

A

bind to protease which inhibits protein cleavage and inhibits new viral progeny

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11
Q

AE’s of HIV protease inhibitors

A

PR prolongation
QTc prolongation
hyperglycemia
hepatotoxicity
hyperlipidemia
pancreatitis
increases bleeding (no hemophiliacs)
IRIS
Avoid in patients at risk of phenylketonuria
Caution w/ sulfa allergy

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12
Q

MOA of INSTIs

A

inhibit integrase which inhibits DNA transfer which inhibits new viruses

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13
Q

HIV INSTI drugs

A

“-tegr-“

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14
Q

Special consideration for raltegravir?

A

Avoid in patients at risk for phenylketonuria

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15
Q

AE’s of INSTIs

A

nephrotoxicity
lactic acidosis
hepatotoxicity
depression
IRIS

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16
Q

Classes of Influenza drugs

A

Neuraminidase inhibitors
Polymerase acidic protein endonuclease inhibitor

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17
Q

MOA of neuraminidase inhibitors

A

bind to viral neuraminidase which inhibits the release of virus from sialic acid and inhibits viral spreading

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18
Q

Neuraminidase inhibitor drugs?

A

Oseltamivir (Tamiflu)
Zanamivir (Relenza)
Peramivir (Rapivab)

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19
Q

Tamiflu: treatment or prophylaxis?

A

both

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20
Q

Relenza: treatment or prophylaxis?

A

both

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21
Q

Rapivab: treatment or prophylaxis?

A

treatment only

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22
Q

AE’s of Tamiflu?

A

Skin rxn
Neuropsych rxn

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23
Q

Special consideration for Relenza?

A

Not used in asthma/COPD

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24
Q

AE’s of Rapivab?

A

Skin rxn
hallucinations
neuropsych rxn

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25
Q

MOA of PA protein endonuclease inhibitor?

A

inhibit endonuclease which inhibits insertion of viral RNA and inhibits viral replication

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26
Q

PA protein endonuclease inhibitor drug?

A

Baloxavir marboxil (Xofluza)

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27
Q

Xofluza: treatment or prophylaxis?

28
Q

Special considerations for Xofluza?

A

Avoid with dairy, Ca, Mg, Fe, Se, Zn, Al

29
Q

AE’s of Xofluza?

A

Anaphylaxis
urticaria
neuropsych rxn

30
Q

Classes of CMV drugs?

31
Q

CMV NRTI drugs?

A

Ganciclovir
Valganciclovir
Cidofovir

32
Q

CMV NNRTI drug?

33
Q

Which has a higher oral bioavailability: ganciclovir or valganciclovir?

A

Valganciclovir

34
Q

AE’s of Ganciclovir/Valganciclovir?

A

nausea
vomiting
bone marrow suppression
sterility

35
Q

AE’s of Cidofovir?

A

nephrotoxicity
neutropenia
uveitis
metabolic acidosis

36
Q

What can be done to decrease the risk of nephrotoxicity with Cidofovir?

A

Prehydrate with saline
Take Probenecid (gout rx): decreases renal tubular secretions

37
Q

Special considerations for Cidofovir?

A

Do not take if sulfa allergic

38
Q

AE’s of Foscarnet?

A

nephrotoxicity
electrolyte wasting (seizures)
anemia
neutropenia
dizziness
QTc prolongation

39
Q

Hep A medications?

A

JUST VACCINES: havrix, vaqta

40
Q

Hep B vaccines?

A

Recombivax
Twinrix
Engirex

41
Q

Hep C vaccines?

A

There aren’t any

42
Q

Classes of Hep B drugs?

A

NRTI - for chronic Hep B

43
Q

Hep B NRTI drugs?

A

Tenofovir
Entecavir
Adefovir
Lamivudine

44
Q

AE’s of Hep B NRTIs

A

renal impairment
IRIS
decreased bone mineral density
lactic acidosis
hepatomegaly
nausea
vomiting
diarrhea
HA

45
Q

Special considerations for Hep B NRTIs

A

Risk of acute Hep B after discontinuing therapy
Monitor renal impairment
Potential HIV resistance

46
Q

Drug classes for Hep C?

A

RNA polymerase inhibitors
NS5A protein inhibitors
Protease inhibitors

47
Q

1st line drugs for Hep C?

A

Epclusa and Mavyret (treats all 6 genotypes)

48
Q

Hep C RNA polymerase inhibitor drugs?

A

” -buvir”

49
Q

Hep C NS5A protein inhibitor drugs?

A

“-asvir”

50
Q

NS5A protein inhibitor MOA?

A

bind to NS5A protein which inhibits RNA replication and inhibits viral progeny

51
Q

Special consideration for NS5A protein inhibitors?

A

Bradycardia if taken w/ ambiodarone, BB, or patients with cardiac disease

52
Q

AE’s of NS5A protein inhibitors?

A

increased ALT
increased bilirubin
fatigue
skin rash
anemia
HA
nausea

53
Q

Hep C protease inhibitor drugs?

A

” -pr(a/e)vir”

54
Q

AE’s of Hep C protease inhibitors?

A

SJS
anemia
HA
neutropenia
nausea
dysgeusia

55
Q

What are the mRNA vaccines for covid?

A

Pfizer and Moderna

56
Q

MOA of mRNA vaccines?

A

mRNA encoded for viral spike protein enters host cell mRNA and triggers covid antigens which triggers antibody immune reponse

57
Q

Novavax MOA?

A

directly inject version of spike protein which triggers antibody immune response

58
Q

Monoclonal antibody drugs?

A

“-mab”

59
Q

Why are monoclonal antibodies not very useful in treating covid?

A

Rapid genomic changes in spike protein antigenic components (new variants!)

60
Q

non-vaccine PrEP for covid?

61
Q

Convalescent plasma use in covid?

A

Processed blood plasma from donors who recovered from covid infections.
Used for hospitalized immunocompromised patients only

62
Q

Protease inhibitors for covid?

63
Q

Why does paxlovid have Ritonavir (an HIV drug)?

A

Ritonavir is a CYP3A4 inhibitor; slows metabolism of Nirmatrelvir, increases half life and serum concentrations

64
Q

NRTIs for covid?

A

Lagevrio
Remdesivir

65
Q

Drug class for Herpes?

A

Antinucleoside inhibitors

66
Q

MOA of anti nucleoside inhibitors?

A

nucleoside analogs get picked up by DNA polymerase and incorporated into DNA and inhibit full DNA replication

67
Q

Herpes anti nucleoside inhibitor drugs?

A

Acyclovir
Valcyclovir
Famciclovir
Panciclovir

Pharm (2 decks)

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