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Step 1 - Microbiology > Antivirals > Flashcards

Antivirals Flashcards

1
Q
  • Oseltamivir
  • Zanamivir
A
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2
Q
  • Acyclovir
  • Famciclovir
  • Valacyclovir
A
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3
Q

Ganciclovir

A
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4
Q

Foscarnet

A
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5
Q

Cidofovir

A
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6
Q

NRTIs (mechanism)

Nucleoside Reverse Transcriptase Inhibitors.

A
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7
Q

NRTIs (clinical)

Nucleoside Reverse Transcriptase Inhibitors.

A
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8
Q

Integrase Inhibitors

The Tegravirs.

A
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9
Q

Protease Inhibitors (mechanism)

A
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10
Q

Protease Inhibitors (clinical use)

A
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11
Q

NS5A Inhibitors

A
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12
Q

NS5B Inhibitors

A
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13
Q

NS3/4A Inhibitors

A
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14
Q

Oseltamivir is structurally and analog of what?

A

Sialic acid analogs.

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15
Q

Off-target adverse effect of Ganciclovir?

A
  • Bone marrow supression
  • Nephrotoxicity
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16
Q

Most likely reason for resistance to Acyclovir (HSV/VZV) and Ganciclovir (CMV):

A
  • Resistance to viral thymidine kinase (acyclovir)
  • Resistance to CMV kinase (ganciclovir)
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17
Q

Foscarnet’s 3 actions & structure:

A

Pyrophosphate analog

Inhibits:
1. viral DNA polymerase
2. viral RNA polymerase
3. HIV reverse transcriptase

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17
Q

Acyclovir’s action & structure?

A

Guanosine analog.

Inhibits
* Viral DNA Polymerase

18
Q

Cidofovir’s action & structure:

A

Cytidine monophsophate analog.

Inhibits:
* Cellular kinases (NOT viral kinases)

19
Q

NRTI drug names

A
  1. Abacavir
  2. Zidovudine
  3. Emtricitabine
  4. Lamivudine
  5. Dianosine
  6. Stavudine
  7. Tenofovir
20
Q

What’s special about the NRTI Tenofovir?

A

It doesn’t require phosphorylation because it already comes in a nucleotide form.

21
Q

Distinguishing Didanosine from the other 6 NRTIs?

A

Pancreatitis.

22
Q

Distinguishing Zidovudine from the other 6 NRTIs?

A

Bone marrow suppression & anemia.

  • Can be reversed with G-CSF and EPO
23
Q

Distinguishing Abacavir from the other 6 NRTIs?

A

Hypersensitivity (Type 4) with HLA B57:01 allele

24
Q

NNRTIs (mechanism)

25
Q

NNRTIs (clinical)

26
Q

How do NRTIs work?

A

They are competitive inhibitors of Reverse Transcriptase.
* Nuceloside analogs that pretend to be DNA building blocks
* Fit into the enzyme’s active site

27
Q

How do NNRTIs work?

A

They bind Reverse Transcriptase at a location different from the active site (where NRTIs bind).

28
Q

NNRTI drug names

A
  1. Efavirenz
  2. Nevirapine
  3. Delavirdine
29
Q

Efavirenz (NNRTI) has what interesting side effect?

A

Vivid dreams.

30
Q

HAART regimen.

A

Usually 3 drugs
* 2 NRTIs
* Integrase or Protein Inhibitor

31
Q

Distinguishing Integrase Inhibitors from the other antiviral therapies?

A

Myositis in patients
* Increase in creatine kinase on bloodwork

Also, it is actively against both HIV-1 & HIV-2.

32
Q

Protease Inhibitor drug names

A
  1. Atazanavir
  2. Darunavir
  3. Indinavir
  4. Lopinavir
  5. Ritonavir
  6. Saquinavir
  7. Fosamprenavir
33
Q

Entry Inhibitors
* Enfuvirtide

Antiviral peptide that targets viral fusion.

34
Q

Entry Inhibitors
* Maraviroc

Antiviral peptide that targets viral fusion.

35
Q

Indinavir (protease inhibitor) is known to cause what specific adverse effects?

A
  1. Renal Toxicity
  2. Thrombocytopenia
36
Q

Adverse profile for the Protease Inhibitor class:

A
  1. Hyperglycemia – can cause diabetes
  2. GI Upset
  3. Cushing-like syndrome (CYP-450 enzymes)
  • **Avoid use of rifampin **(TB drug) due to CYP450 induction
37
Q

Ritonavir (protease inhibitor) is known to cause what specific adverse effect?

A

Inhibits CYP-450 enzymes
* May be used to “boost” the concentration of other drugs metabolized by the liver.

38
Q

CCR-5 is present on which cells?

A

Monocytes and macrophages

39
Q

For which virus are NS5A, NS5B, & NS3/4A Inhibitors prescribed?

A

Hepatitis C virus.

NS5A Inhibitors
* Ledipasvir
* Ombitasvir
* Velpatasvir

NS5B Inhibitors
* Sofosbuvir
* Dasabuvir

NS3/4A Inhibitors
* Grazoprevir
* Simeprevir

40
Q

What exactly do NS5B Inhibitors target to inhibit viral replication?

A

Inhibition of viral RNA-dependent RNA polymerase.

41
Q

What exactly do NS5A Inhibitors target to inhibit viral replication?

A

Inhibition of viral phosphoprotein (NS5A).

42
Q

What exactly do NS3/4A Inhibitors target to inhibit viral replication?

A

NS3/4A, a viral protease.

Step 1 - Microbiology (10 decks)

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