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Antivirals Flashcards

1
Q

What are the Neuraminidase Inhibitors?

A

Oseltamivir (Tamiflu)
Zanamivir ( Relenza)
Permavir (Rapivab)

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2
Q

What are the Adamantanes (M2 Inhibitors)?

A

Amantadine (Symmetrel)
Rimantadine (Flumadine)

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3
Q

Which flu to the neuraminidase inhibitors act against?

A

Both Flu A and B

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4
Q

Which flu do the Adamantanes act against?

A

Only Flu A

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5
Q

When would adamantanes be recommended?

A

In selected circumstances such as known resistance to oseltamivir

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6
Q

What are the side effects of Neuraminidase inhibitors?

A

N/V
Bronchospasm

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7
Q

Which Neuraminidase inhibitor should be given IV?

A

Peramivir

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8
Q

Which Neuraminidase inhibitor should be given inhaled route only?

A

Zanamivir

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9
Q

Which patients should not receive Oseltamivir?

A

Critically ill patients

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10
Q

When should Adamantanes (M2 Inhibitors) be prescribed?

A

Wishing 48 hours of symptoms.

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11
Q

What are the Nucleotide Reverse Transcriptase Inhibitors (NRTIs)?

A

Zidovudine
*Lamivudine
Tenofovir disoproxil fumarate

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12
Q

What is the mechanism of action of Lamivudine?

A

Inhibits HIV replication

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13
Q

What are the rare, serious adverse effects of Lamivudine?

A

Pancreatitis
Aplastic anemia
Lactic acidosis

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14
Q

What drug is in the Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) class?

A

Efavirenz (Sustiva)

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15
Q

What is the mechanism of action of Efavirenz?

A

Binds to HIV reverse transcriptase

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16
Q

What DDI issue with associated with NNRTIs?

A

They have MANY drug interactions

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17
Q

What are the adverse effects of Efanirenz?

A

CNS effects such as insomnia, vivid dreams, dizziness, confusion and hallucinations

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18
Q

What drugs are Protease Inhibitors (PIs)?

A

Ritonavir
Atazanavir
Darunavir

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19
Q

What is the mechanism of action of Ritonavir?

A

Competitive inhibitor; binds to protease; prevents cleavage of polypeptides

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20
Q

What drug is the HIV Integrase Strand Inhibitor?

A

Raltegravir (Isentress)

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21
Q

What is the mechanism action of Raltegravir?

A

Prevents insertion of HIV DNA and stops HIV replication

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22
Q

What drug is the Fusion Inhibitor?

A

Enfuvirtide (Fuzeon)

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23
Q

Who should not be prescribed Fusion Inhibitors?

A

Not recommended for treatment-naïve patients

24
Q

What is the mechanism of action of Enfuvirtide?

A

blocks entry of HIV into CD4 T Cells

25
What drug is the CCR5 Antagonist?
Maraviroc (Selzentry)
26
Who is should not be prescribed CCR5 antagonist?
Not recommended for treatment naïve patients
27
What is the mechanism of action of Maraviroc?
Blocks viral entry of HIV
28
What drug is the CD-4 Attachment Inhibitor?
Fostemsavir (Rukobia)
29
Who should be prescribed CD-4 attachment inhibitors?
For treatment-experienced patient, multi-drug resistant HIV with limited treatment options
30
What is the mechanism of action of Fostemsavir?
Prodrug- converted to active metabolite temsavir Binds to envelope protein to prevent viral attachment to CD4 cells
31
What are the adverse effects of Fostemsavir?
Hepatotoxicity QT prolongation
32
What drug is a Capsid Inhibitor?
Lenacapavir (Sunlenca)
33
What is the mechanism of action of Lenacapavir?
Interferes with protein shell that protects HIV genetic material and enzymes needed for replication
34
What are some DDIs of Lenacapavir?
significant drug interactions include digoxin, direct oral anticoagulants such as rivaroxaban, anticonvulsants such as carbamazepine, and certain antiretroviral agents
35
What are the antivirals used for HSV-1?
Acyclovir Famciclovir Valacyclovir
36
What are the antivirals used for varicella zoster?
Acyclovir Famciclovir Valacyclovir
37
What drugs are used to treat Cytomegalovirus (CMV)?
Nucleoside Analogues: Ganciclovir Valganciclovir Other Antivirals: Foscarnet (DNA chain inhibitor) Cidofovir (inhibits DNA replication)
38
Which drug does not act by inhibiting viral DNA polymerase for HSV infections?
Foscarnet
39
What is the most serious complication of cytomegalovirus?
Retinitis
40
What are the two most opportunistic issues with cytomegalovirus?
Pneumonia
41
What patient population is at risk for cytomegalovirus?
Transplant recipients, 5-13 weeks after surgery
42
What drug can be used prophylactically for CMV?
Valacyclovir
43
What drugs are used for shingles?
Acyclovir, famciclovir, and valacyclovir. They all shorten the duration of acute illness and post therapeutic pain
44
What are the serious side effects of IV acyclovir?
Phlebitis and reversible renal dysfunction
45
What drug is used to treat CMV disease?
Ganciclovir
46
How do you prevent resistance NRTIs in HIV therapy?
Don't use single agent for 6 months or longer. Need combination therapy
47
Which antiviral can help reduce in utero transmission of HIV?
Zidovudine
48
Which drugs are always used in combination due to development of rapid resistance?
NNRTIs - Efavirenz
49
What is the most common side effect of NNRTIs?
Rash - can progress to Steven Johnsons syndrome
50
What drug is known as booster therapy with PIs?
Ritonavir
51
What therapeutic effect does enfuvirtide have?
Increase CD4 count and reduces viral load
52
What is the preferred regimen for treating HIV infections?
INSTI (Raltegravir) or PI (Ritonavir) in combination with 2 NRTIs (Efavirenz)
53
What should be done if a HIV drug regimen is failed?
A new regimen of at least two new drugs needs to be started
54
How is Hepatitis B spread?
Through blood or semen
55
What drug treats HSV and VZV in acyclovir resistant?
Foscarnet

Pharmacology (18 decks)

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