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Kaplan Pharm > Antivirals > Flashcards

Antivirals Flashcards

1
Q

Amantadine MOA and Use

A

blocks attachment, penetration, and uncoating of Influenza A

use: prophylaxis, reduces duration of flu by 1-2 days

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2
Q

SE of Amantadine

A

atropine-like peripheral effects, livedo reticularis

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3
Q

Enfuvirtide MOA and use

A

binds gp41 and inhibits fusion of HIV1 to CD4 cells (chemokine receptor but drug is large enough to block gp120 which blocks fusion)

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4
Q

Maraviroc moa and use

A

blocks CCR5 protein on T cell membrane to prevent viral entry
use: HIV

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5
Q

Acyclovir moa

A

phosphorylation by THYMIDINE KINASE –> incorporated into DNA molecule–> chain terminator (lacks 3’OH)
*inhibits DNA polymerase

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6
Q

Acyclovir resistance

A

changes in DNA polymerase or decreased TK activity

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7
Q

Acyclovir uses

A

HSV

VZV

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8
Q

Why might a patient need multiple treatments with acyclovir?

A

it only works on dividing virus so if it is dormant, it is not killed

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9
Q

SE of Acyclovir

A

crystalluria, neurotoxicity

* NOT hematotoxic

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10
Q

Name the viral DNA polymerase inhbitors

A 
acyclovir
famciclovir
valacyclovir
ganciclovir
foscarnet
**pro-drugs
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11
Q

What are the newer versions of acyclovir? Why would you use them?

A

famciclovir
valacyclovir
longer t1/2 than acyclovir
may work on acyclovir resistant strains as long as they have TK

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12
Q

Gancyclovir use

A

HSV, VZV: uses Tk for phosphorylation
CMV: uses phosphotransferase
**prophylaxis and tx of CMV in AIDS and transplantation

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13
Q

Gancyclovir SE

A

dose limiting hematotoxicity (leukopenia), mucositis, fever, rash, crystalluria (nephrotox), seizures (neurotox)

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14
Q

Foscarnet MOA

A

NOT an anti-metabolite
blocks DNA and RNA polymerases
*doesn’t require TK

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15
Q

Foscarnet use

A

acyclovir-resistant HSV

CMV, VZV

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16
Q

Foscarnet SE

A

dose limiting acute tubular necrosis, hypocalcemia

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17
Q

Foscarnet drug interactions?

A

Pentamidine, will cause hypocalcemia

furosemide

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18
Q

Ribivarin MOA

A

monophosphorylase inhibits IMP dehydrogenase, triphosphorylated inhibits viral RNA polymerase

19
Q

Ribivarin SE

A

hematotoxic, upper airway irritation, teratogenic!

20
Q

Ribivarin use

A 
adjunct to alpha interferon 
Hep C
RSV
Lassa fever
hantavirus
21
Q

What is an NRTI?

A 
nucleoside reverse transcriptase inhibitor
pro-drugs
chain terminators
activated by nonspecific kinases
use with protease inhib. --> HAART
22
Q

What is HAART?

A

highly active acute retroviral therapy

uses NRTI + protease inhibitor

23
Q

What is the moa of NRTIS?

A

competes with natural nucleotides to inhibit reverse transcriptase and can also be incorporated into DNA to cause chain termination

*all work in the same way just with different base analogs

24
Q

NRTI resistance?

A

mutation in gene for reverse transcriptase

there isn’t complete cross resistance between different NRTIs

25
Q

Zidovudine

A

NRTI

SE: bone marrow suppression (SEVERE), headaches, fatigue, myalgias

26
Q

Other names for Zidovudine

A

Azidothymidine, ZDV, AZT

27
Q

Didanosine names and SE

A

DD1

SE: pancreatitis, peripheral neuropathy

28
Q

Abacavire

A

NRTI
SE–> allergies
aka: ABC

29
Q

zalcitabine

A 
NRTI
aka: DDC
SE: peripheral neuropathy
pancreatitis
*don't combine with didanosine
30
Q

lamivudine

A

NRTI
aka: 3TC
SE: least toxic, some GI sx
also used in Hep B

31
Q

Emtricitabine

A

newer, more active version of lamivudine

aka FTC

32
Q

Stavudine

A

NRTI
aka: D4T
dont use with AZT because they have the same base analog
Se: myelosuppression, peripheral neuropathy

33
Q

NNRTI

A

not pro-drugs
no myelosuppression
additive/ synergistic with NRTIs

34
Q

Nevirapine

A

NNRTI
single does at delivery decreases transmission of HIV from mom to baby (vertical transmission) by 50%
CYP450 inducer
SE: rash, increased LFT

35
Q

Efavirenz

A

NNRTI

SE: insomnia, nightmares (dysphoric dreams)

36
Q

Viral aspartate protease inhibitors moa

A

aspartate protease enzyme contains dipeptide structure that isn’t human form so it binds here to inhibit it

37
Q

Viral aspartate protease inhibitors resistance

A

point mutations in pol gene, incomplete cross resistance

38
Q

Common SE of Viral aspartate protease inhibitors

A

disordered lipids and carb metabolism with central adiposity and insulin resistance
*less with atazanavir

39
Q

Indinavir

A

Viral aspartate protease inhibitor
used most frequently
SE: crystalluria

40
Q

Ritonavir

A

Viral aspartate protease inhibitor
used most frequently
SE: major drug interactions from P450 induction

41
Q

Saquinavir

A

Viral aspartate protease inhibitors
least toxic
low bioavailability
predisposes to resistance

42
Q

viral neuraminidase inhibitors

A

influenza A and B
decreases liklihood that virus will penetrate uninfected cells
use: prophylaxis may decrease flu sx
SE: flu sx

43
Q

Raltegravir

A

integrase inhib.
prevents integration of viral genome into host DNA
Use: HIV

44
Q

Human interferons use

A

Hep B, C, D (alpha interferon)
Kaposi sarcoma, CML, MM, RCC (alpha)
MS (beta)
Chronic granulomatous disease (gamma)

Kaplan Pharm (3 decks)

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