Antivirals Flashcards
Which antiviral medications block viral penetration/uncoating?
amantadine (uncoating) , enfuviritide, maraviroc (penetration)
Which antiviral drugs inhibit viral DNA polymerases?
acyclovir, foscarnet, ganciclovir
Which antiviral drugs inhibit viral RNA polymerases?
Foscarnet, ribavirin
Which antiviral drugs inhibit viral reverse transcriptase?
zidovudine, didanosine, zalcitabine, lamivudine, stavudine, nevirapine, efavirenz
Which antiviral drugs inhibit viral aspartate protease?
indinavir, ritonavir, saquinavir, nelfinavir
Which of the antiviral medications inhibit viral integrase?
raltegravir
Which antiviral agent inhibit viral neuraminidase?
Zanamivir, oseltamivir
For viral drugs what is a trick to determine the use of most?
avir aids
ivir for influenza
over for “O shit I have herpes”
How can the herpes virus confer resistance to ovir agents?
can dec production thymidine kinase or completely get rid of TK (- TK strain)
S/E of acyclovir?
crystalluria mainly
Gancyclovir indication.
HSV, VZV, CMV
S/E gancyclovir?
crystalluria
MOA foscarnet and how it is different from ganciclovir and acyclovir?
not an antimetabolite so doesn’t need to be phosphorylated but does inhibit viral DNA and RNA polymerase
Describe the purpose of HAART in treating HIV?
HAART Highly active antiretroviral therapy:
decreases viral RNA,
reverses decline in CD4 cells
dec. the risk of opportunistic infections
What is tenofovir and what is it commonly coformulated with?
an NtRTI commonly formulated with an NRTI
has a single phosphate residue and must be further phosphorylated to the triphosphate form
Tenofovir unlike NRTIs doesn’t require what?
one phosphorylation step which is usually from the virus itself
What drug class does Zidovudine, AZT belong to?
NRTI
What drug class does Didanosine, DDI belong to?
NRTIs
what drug class does Lamivudine, 3TC; emtricitabine FTC belong to?
NRTIs
Zidovudine is what analog?
thymidine
Didanosine is an analog of what?
inosine
Lamuvidine is an analog of what?
cytosine
Major S/Es of NNRTIs?
vivid dreams, maculopapular rash
S/E zidovudine?
Bone marrow supression
S/E didanosine?
pancreatitis, peripheral neuropathy, hyperuricemia, liver dysfunction
What are the S/E of lamuvidine and emtricitabine?
least toxic of NRTIs, but some GI effects and neutropenia
Best HIV prophylaxis post exposure prophylaxis drugs?
emtricitabine + tenofovir + raltegravir
Best regimen for HIV prophylaxis during pregnancy?
2 NRTIs (emtricitabine or lamivudine) + (zidovudine or tenofovir) + ritonavir-boosted atazanavir or lopinavir
What is the best method to go about treating HIV in general?
Integrase inhibitors combined with 2 NRTIs are used as complete treatment regimens
NNRTIs have additive or synergistic effects when used in combination with what other antivirals?
NRTIs or protease inhibitors
MOA of PI (protease inhibitors) ?
aspartate protease (pol gene encoded) is a viral enzyme that cleaves precursor polypeptides in HIV buds to form the proteins of the mature virus core
What are the S/Es of indinavir?
crystalluria
S/E, in general, of most protease inhibitors?
syndrome of disordered lipid and CHO metabolism central adiposity and insulin resistance
MOA Intergrase inhibitors?
prevents integration of viral genome in host cell DNA
Suffix to remember the integrase inhibitors?
tegravirs
Name the antiviral medications considered fusion inhibitors?
enfuvirtide, maraviroc
Basic MOA of enfuvirtide and maraviroc?
block entry of HIV into cells
MOA enfuvirtide?
binds to gp41 and inhibits the fusion HIV-1 to CD4+ cells
MOA maraviroc?
blocks the binding of the gp120 HIV protein to CCR5 on macrophage surface to prevent viral entry
Are amantadine and rimantadine still used for prophylaxis of influenza A?
no
MOA zanamivir and oseltamivir (tamiflu)
inhibit neuraminidase of influenza A and B (enzymes that prevent clumping of virions so that more particles are available for infecting host cells)
Indication zanamivir and oseltamivir?
prophylaxis mainly, but may decrease duration of flu symptoms by 2-3 days
MOA ribavirin?
inhibits IMP dehydrogenase and RNA polymerase
Indication for use of ribavirin?
combined with Alpha-interferons for hep C; Lassa fever and Hantavirus
S/E of ribavirin use?
anemia
MOA sofosbuvir? Use?
nucleotide analog that inhibits RNA polymerase;
Hep C
What is Sofosbuvir usually combined with to make it more effective?
ribavirin or INT-a
MOA of Simeprevir and use?
hepatitis C protease inhibitor
What is simeprevir usually combined with?
ribavirin or INT-a
What is the MOA of ledipasvir and use?
inhibits HCV NS5A protein that plays a key role in RNA replication and secretion
What is the best way to remember the proteins associate with Hep C targets?
USE me for Hep C
USE backwards
Evir (NS3/4A)
Svir (NS5A)
Uvir (NS5B)
