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Antivirals Flashcards

1
Q

Palivizumab

A

monoclonal antibody against F protein; prevents pneumonia caused by RSV in premature infants

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2
Q

HIV env protein

A

= gp120 (attachment) + gp41 (penetration)

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3
Q

fusion inhibitor that binds to gp41

A

Enfuviritide

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4
Q

fusion inhibitor that binds CCR5 on surface of T cells, inhibiting interaction with gp120

A

Maraviroc

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5
Q

Enfuviritide and Maraviroc are what?

A

fusion inhibitors

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6
Q

What is Raltegravir?

A

integrase inhibitor

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7
Q

What is -navir?

A

protease inhibitor

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8
Q

Nevirapine,
Efavirenz,
Delaviridine

A

NNRTIs

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9
Q

gag (p24) =

A

HIV capsid protein

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10
Q

What type of virus is HIV?

A

+ linear ssRNA

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11
Q

What is the only dsRNA virus?

A

Rotavirus (and coltivirus = colorado tick fever)

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12
Q

What does HIV bind on T cells?

A

CCR5 (early) or CXCR4 (late) and CD4

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13
Q

What does HIV bind on macrophages?

A

CCR5 and CD4

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14
Q

What mutation confers HIV immunity

A

homozygous CCR5

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15
Q

ELISA/Western blot may be falsely HIV+ for newborn because?

A

anti-gp120 crosses the placenta

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16
Q

HIV patient (CD4 <100) with low-grade fevers, cough, HSM, tongue ulcer; oval yeast forms within macrophages

A

Histoplasma

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17
Q

Normal CD4 count

A

500-1500

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18
Q

Hairy leukoplakia often presents on lateral tongue in HIV+ pt and is associated with

A

EBV

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19
Q

HIV + pt w/ superficial vascular proliferation in which biopsy reveals NEUTROPHILIC inflammation

A

Bartonella henselae (bacillary angiomatosis)

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20
Q

HIV+ pt (CD<200) with chronic watery diarrhea; acid-fast cysts in stool

A

Cryptosporidium

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21
Q

Many ring enhancing lesions in brain of HIV+ pt (CD4<100)

A

Toxo

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22
Q

Encephalopathy due to reactivation of latent virus in HIV+ pt (CD4< 200); results in demyelination

A

JC virus (causes PML)

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23
Q

HIV+ pt w/ meningitis

A

Cryptococus neoformans

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24
Q

HIV+ pt with retinitis

A

CMV

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25
HIV + pt w/ superficial vascular proliferation in which biopsy reveals LYMPHOCYTIC inflammation
HHV8 - Kaposi sarcoma
26
HIV+ pt w/ interstitial pneumonia; biopsy reveals cells with intranuclear inclusion bodies
CMV
27
HIV+ pt w/ pleuritic pain, hemoptysis, infiltrates on imaging
Aspergillus
28
HIV+ pt w/ pneumonia w/ ground glass appearance on imaging
PCP
29
Pneumonia when CD4 count > 200
S pneumo
30
HIV pt w/ TB like disease, except that it grows well at 41C
Mycobacterium avium-intracellulare (MAC), prophylaxis is azithromycin
31
Inhibits influenza neuraminidase --> decreased RELEASE of progeny visions; used for treatment and prevention of influenza A + B
Oseltamavir, Zanamivir
32
Inhibits synthesis of guanine nucleotides by competitively inhibiting inosine monophosphate dehydrogenase;
Ribavirin
33
Ribivarin MOA
inhibits guanine synthesis by inhibiting IMP DH
34
Ribavirin CU
RSV, chronic HCV
35
Ribavirin SE
hemolytic anemia, severe teratogen
36
Guanosine analog that is phosphorylated by HSV/VZV thymidine kinase and not phosphorylated in uninfected cells --> few adverse effects. Triphosphate formed by cellular enzymes. Preferentially inhibits viral DNAP by chain polymerase by chain termination.
Acyclovir, famciclovir, valacyclovir (better oral availability)
37
Best drug for HSV
Acyclovir
38
Best drug for VZV
Famciclovir
39
Acyclovir SE
obstructive crystalline nephropathy and acute RF if not adequately hydrated
40
Acyclovir MOR
Mutated viral thymidine kinase
41
5' monophosphate formed by a CMV viral kinase. Guanosine analog. Triphosphate formed by cellular kinases. Preferentially inhibits viral DNAP
Ganciclovir
42
Best drug for CMV
Ganciclovir
43
Ganciclovir SE
leukopenia, neuropenia, thrombocytopenia, renal toxicity
44
Ganciclovir MOR
Mutated CMVP or lack of viral kinase
45
Drug for acyclovir resistant HSV and ganciclovir resistant CMV retinitis (immunocompromised patient)
Foscarnet
46
Viral DNAP inhibitor that binds to the pyrophophate-binding site of the enzyme. DOES NOT REQUIRE ACTIVATION BY A VIRAL KINASE
Foscarnet
47
Foscarnet SE
nephrotoxicity
48
Foscarnet MOR
mutated DNA polymerase
49
Viral DNAP inhibitor that does not require phosphorylation by viral kinase.
Cidofovir
50
Cidofovir CU
CMV retinitis in immunocompromise; acyclovir-resistant HSV
51
Cidofovir SE
Nephrotoxicity (coadminister w/ probenecid and IV saline)
52
Which protease inhibitor can booth other drug concentrations by inhibiting cyctochrome P450?
Ritonavir
53
Protease inhibitor SE
Hyperglycemia, GI intolerance, lipodystrophy
54
What protease inhibitor additionally has the side effects of nephrotoxicity and hematuria?
Indinavir
55
What NRTI does not need to phosphorylated to be active?
Tenofovir (nucleotides)
56
What is the prototypical NRTI that is used general prophylaxis and during pregnancy to decrease the risk of fetal transmission?
Zidovudine
57
NRTI SE
bone marrow suppression (can be reversed with G-CSF and epo), peripheral neuropathy, lactic acidosis (nucleosides), anemia (ZDV), pancreatitis (didanosine)
58
NNRTIS
Efavirenz Nevirapine Delaviridine
59
NNRTI MOA
bind to reverse transciptase at site different from NRTI. Do not require phosphorylation to be active or compete with nucleotides.
60
NNRTI SE
rash and hepatotoxicity
61
Efavirenz SE
Vivid dreams, CNS sympatoms
62
NNRTIs that are c/i in pregnancy
Delarviridine, Efavirenz | leaves Nevirapine
63
Inhibits HIV genome integration by reversibly inhibiting HIV integrase
Raltegravir
64
Raltegravir SE
Hypercholesterolemia
65
Glycoproteins normally synthesized by virus-infected cells, exhibiting a wide range of antiviral and anti tumor properties
IFNs
66
IFN-alpha CU
HBV + HCV
67
IFN-beta CU
MS
68
IFN-gamma CU
CGD
69
IFN SE
neutropenia, myopathy

Drugs (21 decks)

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