Antivirals Flashcards
What is the common mechanism used to treat DNA virus infections?
Drugs that are analogs of ‘essential chemicals,’ i.e. nucleosides and pyrophosphates
How are antivirals for DNA viruses delivered (molecularly)?
As inactive prodrugs that are activated by a viral enzyme
What enzyme present in cells infected by HSV and VZV activates acyclovir to its nucleoside analog active state?
Thymidine kinase
In a patient with unknown (or missed) renal insufficiency, what may happen if they are given acyclovir?
seizures and altered mental status
Ganciclovir is an analog of what nuceotide?
Guanine
Ganciclovir is used for what viral infection? Specifically what is the most common manifestation it is used to treat?
CMV; CMV retinitis in HIV
Which has more adverse effects, acyclovir or ganciclovir?
Gancyclovir: neutropenia, thrombocytopenia, and CNS
What drug is important in the scenario of acyclovir resistant strains as well as in CMV infections? Does it have tox issues?
Foscarnet: some dose dependent renal and CNS tox
When would you use oseltamivir prophylactically? What is a concern in this use?
high risk confined patients and for family members of the ill; neuropsychiatric side effects in already nervous people
What molecular target of oseltamivir is critical for viral shedding?
Neuraminidase
How long after symptoms start can oseltamivir be used?
1-2 days
What 2 drugs act as nucleotide reverse transcriptase inhibitors? What viruses do they affect?
Zidovudine (AZT) for HIV and Lamivudine for HIV and HBV
Which NRTI can be given IV?
Zidovudine (AZT)
Which antiviral inhibits reverse transcriptase from outside the nucleotside binding site? What 2 concerns are given in its use?
Efavirenz (a NNRTI); has resistance concerns and all in its class cause rash
Protease inhibitors: Amprenavir, bocepravir, ritonavir, and telepravir. Which are for HCV and which for HIV?
HIV: amprenavir and ritonavir
HCV: bocepravir and telepravir
