Antivirals Flashcards
Valacyclovir unique characteristics? (3)
increased bioavailability
absorption not effected by food
fewer doses
Acyclovir use (3)
DOC herpes
organ transplant prophylaxis
chronic for immunocompromised
Acyclovir SE
nephrotoxic w/ high IV doses
Docosanol MOA and use
inhibits viral fusion to cell membrane- virus can’t enter the cell
OTC for cold sore
Ganciclovir SE (4)
neutropenia
thrombocytopenia
seizures
abnormal LFTs
Cidofovir use and SE
resistant CMV and herpes
renal toxicity- need to use probenecid or hydrate
Foscarnet use (2) and toxicity?
IV
resistant CMV and herpes
renal toxicity
Fomvirsen MOA, use, and SE (2)
antisense compound to viral mRNA
intraocular for CMV retinitis
ocular inflammation, visual haze
Oseltamivir (Tamiflu) use (2) and dose (2)
influenza, bird flu
oral, take w/ food to prevent N/V
Zanamivir (Relenza) use (2), and cautions
influenza A and B
inhaled/nasal
caution in COPD, asthma
Amantidine MOA, use, and SE (2)
inhibits viral uncoating
treatment and prophylaxis of flu A
hallucinations, N/V
Rimantidine characteristics
no CNS entry- no hallucinations
ribavirin MOA (2), forms (3)
purine analogue- inhibits viral RNA synthesis
inhibits RNA polymerase
aerosol, IV, oral
Ribavirin use (3), SE (4)
RSV
hep C (w/ interferon)
SARS
pulm. toxicity, anemia, depression, teratogenic
Palivizumab MOA & use
Ab to RSV
injection prophylaxis for high risk pts once/mo.
Lamivudine MOA & use (2)
reverse transcriptase inhibitor
DOC for Hep B
HIV w/ Zidovudine
Adefovir use & SE (2)
Hep B
renal toxicity, lactic acidosis
Entacavir use
Hep B
Interferon MOA
interferes w/ every stage of replication: blocks viral entry, transcription/translation of mRNA, viral processing, viral release
Interferon SE (5)
flu-like sx nausea depression ** neutropenia anemia
Boceprevir, Telaprevir, Simeprevir MOA
inhibit serine protease needed for Hep C replication
Boceprevir, Telaprevir, Simeprevir SE (4)
incr. effect w/ interferon/ribavirin
exacerbate anemia, neutropenia, fatigue assoc. w/ ifn-alfa/ribavirin
Sofosbuvir/Lepidasivir MOA & SE (3)
halts HCV reproduction
irritability**
fatigue
lethargy
Dasabuvir, Ombitasivir, Paritaprevir, Ritonavir (Viekira) MOA, SE (2)
inhibit RNA polymerases
fatigue
insomnia
Zidovudine (Retrovir) use (5)
combined w/ lamivudine enters CNS- can treat AIDs dementia prophylaxis safe in pregnancy- decr. transmission to newborns
Zidovudine (Retrovir) SE (5)
anemia neutropenia CNS GI somnolence w/ gancyclovir
Tenofovir (Viread)/Emtricitabine (Emtriva) MOA, use, SE (2)
inhibits reverse transcriptase
DOC
mild GI, flatulence
didanosine (ddI, Videx) SE & use
peripheral neuropathy
combo w/ Zidovudine
Zalcitabine (ddC, Hivid) drug type, SE (2)
NRTIs
peripheral neuropathy
oral ulcers
stavudine (Zerit) drug type, SE
NRTI
peripheral neuropathy
NRTIs causing peripheral neuropathy (3)
Didanosine (ddI, Videx)
Stavudine (Zerit)
Zalcitabine (ddC, Videx)
NRTIs causing lactic acidosis (4)
Zidovudine
Zalcitabine
Didanosine
Stavudine
NRTIs causing anemia/granulocytopenia (2)
Zidovudine
Didanosine
NNRTIs (2), use
Efavirenz
Nevirapine
use only w/ nucleoside analogues, interact w/ protease inhibitors
preferred NNRTI? NNRTI for pregnancy?
Efavirenz
Nevirapine
protease inhibitor DOC?
Atazenavir (Reytaz)
DOC #2 for protease inhibitors
Darunavir (Prezista)
Protease inhibitors SE (5)
altered body fat elevates cholesterol & TGs diabetes depression abd pain
Protease inhibitors tx guidelines (2)
don’t interrupt therapy
many drug interactions - St. John’s Wort
Atazanavir (Reyataz) SE & dose
may incr. bilirubin
once/day dosing
Darunavir (Prezista) SE (2)
HA
nightmares
Saquinavir use cautions (3)
incr. bioavailability w/ high fat diet, grapefruit, or ritonavir
inhibition of CYP3A may cause interactions or toxicity
GI side effects
Ritonavir (Norvir) use (3)
inhibits CYP3A4 metabolism
combined w/ other drugs to increase bioavailability
many drug interactions
Ritonavir SE (3)
GI
burning/tingling
elevated LFTs
Lopinavir/ritonavir (Kaletra) SE (3)
diarrhea
nausea
elevated LFTs w/ hepatic disease
Indinavir (Crixivan) interactions (2) & SE (2)
cross-resistance w/ ritonavir
metabolized by CYP3A4- many drug interactions
kidney stones
hyperbilirubinemia
Amprenavir/Fosamprenavir SE
rash/SJS
Tipranavir (Aptivus) use (2)
non-peptidic protease inhibitor- may work w/ resistance
combined w/ ritonavir
Enfurvirtide (Fuzeon) MOA, use, & SE (2)
binds to viral envelope glycoprotein, prevents fusion of virus & entry into the cell
no cross-resistance with other drugs- used late in disease
injection site rxn
pneumonia
Raltegravir (Isentress) MOA (2), use
blocks integrase,
prevents viral replication
used when other drugs stop working