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Pharm > Antivirals > Flashcards

Antivirals Flashcards

0
Q

What are the 5 classes of antiretroviral medications

A 
NRTI
NNRTI
PI
Integrase inhibitors
Entry inhibitors (enfuviritide; CCR5 antagonist)
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1
Q

Name the 5 NRTIs

A 
Lamivudine (C)
Abacavir (G)
Tenofovir (A)
Emtricitabine (C)
Zidovudine (T)
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2
Q

SE tenofovir

A

Nephrotoxic

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3
Q

SE Abacovir

A

Hypersensitivity

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4
Q

Classic SE NRTI

A

GI

Lactic acidosis

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5
Q

SE Zidovudine

A

Anemia

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6
Q

HAART treatment options

A

(1) PI (+ritonavir) + 2 NRTIs
(2) NNRTI + 2 NRTIs
(3) II + 2 NRTIs

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7
Q

MOA NRTI

A

Viral DNA chain termination via inhibition of reverse transcriptase enzyme

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8
Q

What are the 4 NNRTIs

A

Efavirenz
Nevirapine
Rilpivirine
Etavirine

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9
Q

MOA NNRTI

A

Bind RT directly

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10
Q

SE Efavirenz

A

CNS symptoms
Vivid dreams
Drowsiness
Teratogenic

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11
Q

SE Nevirapine

A

Rash

Hepatitis (hepatic necrosis)

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12
Q

What do all PI end in?

A

NAVIR

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13
Q

MOA PI

A

Bind within active pocket of protease, inhibiting binding of virus (no functional units can be made)

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14
Q

NNRTI class SE

A

Rash 5-10% risk

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15
Q

SE PI

A

GI
Metabolic toxicities
(Hyperglycemia, dyslipidemia, lipodystrophy)

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16
Q

Which PI is given as a booster? (Enhances other drugs)

A

Ritonavir

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17
Q

What is Enfuviritide?

A

An injectable drug used for HIV treatment

Attaches to gp41 and blocks entry

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18
Q

SE Enfuviritide

A

Injection reaction
Increased rate of bacterial pneumonia
Hypersensitivity reaction

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19
Q

What is a CCR5 antagonist?

A

Used for HIV treatment, it blocks entry. HIV used CCR5 as a co-receptor to enter T-cells
*some people have CXCR4

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20
Q

SE Maraviroc

A

Hepatotoxicity

Cough, fever, URT infection, rash, MSK, etc

21
Q

What do Integrase inhibitors end in? What three are available?

A

GRAVIR
Raltegravir
Elvitegravir
Dolutegravir

22
Q

SE Integrase inhibitors

A

Few
N, headache, D, fever
Myopathy has been reported

23
Q

Interferon MOA

A

Induce interferon-stimulated genes (ISGs) that help establish an antiviral state within cells (not virus specific)

24
Q

SE Interferon

A

Flu-like symptoms
Depression
Cytopenias
Fatigue

25
Q

What is ribavirin?

A

Nucleoside analog used for hepatitis C

26
Q

Ribavirin SE

A

Hemolytic anemia

Teratogenic

27
Q

NS5B polymerase inhibitors

A

Sofosbuvir

28
Q

MOA NS5B polymerase inhibitors

A

Inhibit HCV NS5B RNA-dependent RNA polymerase. Once phosphorylated, competes with natural viral nucleotide (uridine) to cause chain termination

29
Q

SE NS5B polymerase inhibitors

A

Fatigue
Headache
GI
Possible anemia

30
Q

NS5A inhibitors

A

Ledipasvir

31
Q

MOA NS5A inhibitors

A

Inhibits HCV NS5a, a viral phospoprotein required for viral replication

32
Q

SE NS5A inhibitors

A

Fatigue
Headache
GI

33
Q

NS3/4A Protease inhibitors

A

Simeprivir
Boceprevir
Telaprevir

34
Q

MAO NS3/4A Protease inhibitors

A

Prevent viral maturation through the inhibition of protein synthesis

35
Q

SE NS3/4A Protease inhibitors

A 
Depends on the agent
Anemia
Rash
Itching
GI
36
Q

Is HCV curable?

A

Yes SVR = cure

37
Q

Is HCV therapy usually combined?

A

Yes

38
Q

MOA of guanosine nucleoside antivirals

A

Because phosphorylation requires viral thymidine kinase, acyclovir and panciclovir are only phosphorylated in infected cells (important for resistance!)

Once phosphorylated, competes with DNA analogues to cause viral DNA chain termination

39
Q

Acyclovir and penciclovir spectrum

A

HSV 1+2

VZV

40
Q

Ganciclovir and foscarnet spectrum

A

CMV*
HSV 1+2
VZV

41
Q

Acyclovir prodrug

A

Valacyclovir

42
Q

Prodrug of penciclovir (topical)

A

Fanciclovir (PO)

43
Q

SE Acyclovir

A

CNS (malaise, confusion, headache)
N/V/D
Renal dysfunction with high doses

44
Q

SE Ganciclovir

A

Myelosuppression (neutropenia, monitor CBC)
CNS toxicity
Hepatotoxicity, GI

45
Q

MOA Foscarnet

A

Directly inhibits herpesvirus DNA polymerase or HIV RT

46
Q

SE Foscarnet

A

Nephrotoxicity
Electrolyte abnormalities
CNS
Myelosuppresion

47
Q

DOC CMV

A

Ganciclovir

48
Q

DOC for resistant HSV

A

Foscarnet

49
Q

Neuraminidase inhibitors

A

Oseltamivir

Zanamivir

50
Q

Neuraminidase inhibitors effects

A

Active against influenza A and B
Reduce complications
More rapid resolution of symptoms

51
Q

SE Neuraminidase inhibitors

A

GI

Neuropsych

Pharm (4 decks)

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