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2014 Rapid Review > Antivirals > Flashcards

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
Q

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

A

HHV8 - Kaposi sarcoma

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26
Q

HIV+ pt w/ interstitial pneumonia; biopsy reveals cells with intranuclear inclusion bodies

A

CMV

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27
Q

HIV+ pt w/ pleuritic pain, hemoptysis, infiltrates on imaging

A

Aspergillus

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28
Q

HIV+ pt w/ pneumonia w/ ground glass appearance on imaging

A

PCP

29
Q

Pneumonia when CD4 count > 200

A

S pneumo

30
Q

HIV pt w/ TB like disease, except that it grows well at 41C

A

Mycobacterium avium-intracellulare (MAC), prophylaxis is azithromycin

31
Q

Inhibits influenza neuraminidase –> decreased RELEASE of progeny visions; used for treatment and prevention of influenza A + B

A

Oseltamavir, Zanamivir

32
Q

Inhibits synthesis of guanine nucleotides by competitively inhibiting inosine monophosphate dehydrogenase;

A

Ribavirin

33
Q

Ribivarin MOA

A

inhibits guanine synthesis by inhibiting IMP DH

34
Q

Ribavirin CU

A

RSV, chronic HCV

35
Q

Ribavirin SE

A

hemolytic anemia, severe teratogen

36
Q

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.

A

Acyclovir, famciclovir, valacyclovir (better oral availability)

37
Q

Best drug for HSV

A

Acyclovir

38
Q

Best drug for VZV

A

Famciclovir

39
Q

Acyclovir SE

A

obstructive crystalline nephropathy and acute RF if not adequately hydrated

40
Q

Acyclovir MOR

A

Mutated viral thymidine kinase

41
Q

5’ monophosphate formed by a CMV viral kinase. Guanosine analog. Triphosphate formed by cellular kinases. Preferentially inhibits viral DNAP

A

Ganciclovir

42
Q

Best drug for CMV

A

Ganciclovir

43
Q

Ganciclovir SE

A

leukopenia, neuropenia, thrombocytopenia, renal toxicity

44
Q

Ganciclovir MOR

A

Mutated CMVP or lack of viral kinase

45
Q

Drug for acyclovir resistant HSV and ganciclovir resistant CMV retinitis (immunocompromised patient)

A

Foscarnet

46
Q

Viral DNAP inhibitor that binds to the pyrophophate-binding site of the enzyme. DOES NOT REQUIRE ACTIVATION BY A VIRAL KINASE

A

Foscarnet

47
Q

Foscarnet SE

A

nephrotoxicity

48
Q

Foscarnet MOR

A

mutated DNA polymerase

49
Q

Viral DNAP inhibitor that does not require phosphorylation by viral kinase.

A

Cidofovir

50
Q

Cidofovir CU

A

CMV retinitis in immunocompromise; acyclovir-resistant HSV

51
Q

Cidofovir SE

A

Nephrotoxicity (coadminister w/ probenecid and IV saline)

52
Q

Which protease inhibitor can booth other drug concentrations by inhibiting cyctochrome P450?

A

Ritonavir

53
Q

Protease inhibitor SE

A

Hyperglycemia, GI intolerance, lipodystrophy

54
Q

What protease inhibitor additionally has the side effects of nephrotoxicity and hematuria?

A

Indinavir

55
Q

What NRTI does not need to phosphorylated to be active?

A

Tenofovir (nucleotides)

56
Q

What is the prototypical NRTI that is used general prophylaxis and during pregnancy to decrease the risk of fetal transmission?

A

Zidovudine

57
Q

NRTI SE

A

bone marrow suppression (can be reversed with G-CSF and epo), peripheral neuropathy, lactic acidosis (nucleosides), anemia (ZDV), pancreatitis (didanosine)

58
Q

NNRTIS

A

Efavirenz
Nevirapine
Delaviridine

59
Q

NNRTI MOA

A

bind to reverse transciptase at site different from NRTI. Do not require phosphorylation to be active or compete with nucleotides.

60
Q

NNRTI SE

A

rash and hepatotoxicity

61
Q

Efavirenz SE

A

Vivid dreams, CNS sympatoms

62
Q

NNRTIs that are c/i in pregnancy

A

Delarviridine, Efavirenz

leaves Nevirapine

63
Q

Inhibits HIV genome integration by reversibly inhibiting HIV integrase

A

Raltegravir

64
Q

Raltegravir SE

A

Hypercholesterolemia

65
Q

Glycoproteins normally synthesized by virus-infected cells, exhibiting a wide range of antiviral and anti tumor properties

A

IFNs

66
Q

IFN-alpha CU

A

HBV + HCV

67
Q

IFN-beta CU

A

MS

68
Q

IFN-gamma CU

A

CGD

69
Q

IFN SE

A

neutropenia, myopathy

2014 Rapid Review (10 decks)

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