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Microbio > Antivirals > Flashcards

Antivirals Flashcards

1
Q

Release of Progeny Virus

A

Neuraminidase inhibitors

Zanamivir and Oseltamivir (Flu A and B)

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2
Q

Nucleic acid synthesis

A

Guanine nucleotide synthesis: Ribavirin (RSV + HCV)

Viral DNA Polymerase inhibitors: Foscarnet and Cidofovir (HSV and CMV)

Guanosine analogs: Ayclovir, etc (HSV,VZV)
Ganciclovir (CMV)

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3
Q

Uncoating

A

Amantadine and Rimantadine

No longer used

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4
Q

Protein Synthesis

A

IFN-a

HBV & HCV

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5
Q

Fusion (HIV)

A

Attachment: Maraviroc

Penetration: Enfuvirtide

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6
Q

Reverse Transcriptase inhibitors (HIV)

A 
NRTIs
Tenofovir (TDF)
Emtricitabine (FTC)
Abacavir (ABC)
Lamivudine (3TC)
Zidovudine (ZDV, use to be AZT)
Didanosine (ddl)
Stavudine (d4T)

NNRTIs
Nevirapine
Efavirenz
Delavirdine

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7
Q

Integrase inhibitors

A

Raltegravir

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8
Q

Protease inhibitors

A 
Lopinavir
Atazanavir
Darunavir
Fosamprenavir
Squinavir
Ritonavir
Indinavir
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9
Q

Zanamivir/Oseltamivir

A

Inhibits influenza Neuramidase. Decrease release of progeny

Influenza A and B

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10
Q

Ribavirin

A

Inhibits gaunaine nulceotides by competitively inhibiting IMP dehydrogenase

RSV, Chronic Hep C

Hemolytic anemia. Severe Teratogen

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11
Q

Acyclovir, Famciclovir, Valacyclovir (Guanosine analogs)

A

Monophosphylated by HSV/VZV thymidine kinase, but not uninfected cells

Guanosine analogs. Triphosphate formed by cellular enzymes. (incorporated to viral DNA)
Preferentially inhibits viral DNA polymerase by chain termination

HSV, VZV, weak against EBV and nothing in CMV.

Mucocutaneous and genital lesions, encephalitis.

Prophylaxis in immunocompromized.

Only in primary infection, not latent.

Vala is a prodrug to acyclo. increase bio avaialbility

HZ –> Famciclovir, releated

Can cause Obstructive cystalline nephropathy, ARF.

Resistance from mutated viral thymidine kinase

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12
Q

Ganciclovir

A

Guanosine analog, but different thymidine kinase*

5 monophosphate formed by CMV viral kinase

Guanosine analong

Triphosphate by cellular kinase.

Preferential to viral DNA polymerase

CMV. Especially immunocompromised

Valganciclovir –> prodrug with better oral

Leukopenia, neutropenia, thrombocytopenia, renal toxicity.
More so than acyclovir

Resistance: Mutated CMV DNA polymerase or lack of viral kinase

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13
Q

Foscarnet

A

Viral DNA polymerase inhibitor that binds to pyrophosphate binding site of the enzyme

Fos = pyroFOSphate analog

Does not require viral kinase activation.

CMV retinitis w/ ganciclovir fail or acyclovir reisstant HSV

Nephrotoxicity, anemia, bad side effects

Resistance from mutated DNA polymerase

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14
Q

Cidofovir

A

Preferentially inhibits viral DNA polymerase, doesn’t need viral kinase

CMV retintis in immunocompromised patients; acyclovir resistant HSV. long 1/2 life

Nephrotoxicity. Coadminister w/ probenecid and IV saline

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15
Q

HAART

A

When AIDS defininig illness or

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16
Q

Protease inhibitors

A

“Navir”

Assembly of virion depends onf HIV-1 (pol) gene. Cleaves polypeptides.

Ritonavir can boost other drug concentrations (inhibits c P450)

Hyperglycemia, hyperlipidemia, GI intolerance, lipidystrophy.

Nephropathy, hematuria w/ Indinavir

Atazanavir –> stones/hyperbili

Indinavir –> stones

Ritonavir –> pancreatitis

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17
Q

NRTIs

A

Abacavir (ABC) (HLA B570
Didanosine (ddI) Pancreatitis/ Hep steatosis
Emtricitabine (FTC)
Lamivudine (3TC)
Stavudine (d4T)
Tenofovir (TDF) - NtRTI
Zidovuide (ZDV/AZT) (anemia, GI, Pregnancy)

Competively inhibits nucleotide binding to RT. Terminates DNA chain.

Requires Thymidine Kinase - Tenofovir

Tenofovir is a nucleotide.

BM suppression (reverse w/ G-CSF and EPO),
peripheral neuropathy
Lactic acidosis (nucleosides)
Rash (nucleotides)

ZDV –> anemia.

ZDV in pregnancy and general prophylaxis (occupation)

ddI –> Pancreatitis

18
Q

NNRTIs

A

Don’t need phosphorylation/thymidine kinase

Efavirenz (neuropsych)
Nevirapine
Delavirdine

Bind to RT at different site. Noncompetetive

Rash, hepatotoxicity

Vivid dreams/CNS in efavirenz.

Delavirdine and efavirenz contraindicated in pregnancy

19
Q

Integrase inhibitors

A

Raltegravir

Inhibits genome intergration

Hypercholesterolemia, hyperglycemia (metabolic), pancreatitis, hepatotoxicity

20
Q

Fusion inhibitors

A

Enfuvirtide (gp41) –> viral entry

Maraviroc (CCR5) –> viral attachment

Skin reactions
at injection sites

can be X4 virus, dont’ give it

21
Q

Atazanavir

A

Protease inhibitor

Stones, hyperbilirubinemia

Hyperglycemia, GI intolerance (nausea/diarrhea), lipodystrophy

22
Q

Darunavir

A

Protease inhibitor

Hyperglycemia, GI intolerance (nausea/diarrhea), lipodystrophy

23
Q

Fosamprenavir

A

Protease inhibitor

Hyperglycemia, GI intolerance (nausea/diarrhea), lipodystrophy

24
Q

Indinavir

A

Protease inhibitor

Hyperglycemia, GI intolerance (nausea/diarrhea), lipodystrophy

Stones, Nephropathy, hematuria

25
Q

Lopinavir

A

Protease inhibitor

Hyperglycemia, GI intolerance (nausea/diarrhea), lipodystrophy

26
Q

Ritonavir

A

Protease inhibitor

Hyperglycemia, GI intolerance (nausea/diarrhea), lipodystrophy

Inhibits p-450

27
Q

Saquinavir

A

Protease inhibitor

Hyperglycemia, GI intolerance (nausea/diarrhea), lipodystrophy

28
Q

Abacavir

A

NRTI
(ABC)

BM suppression (reverse w/ G-CSF and EPO)
Lactic acidosis, peripheral neuropathy,
29
Q

Didanosine

A

NRTI
(ddI)

BM suppression (reverse w/ G-CSF and EPO)
Lactic acidosis, peripheral neuropathy,

Pancreatitis, hepatosteatosis

30
Q

Emtricitabine

A

NRTI
(FTC)

BM suppression (reverse w/ G-CSF and EPO)
Lactic acidosis, peripheral neuropathy,
31
Q

Lamivudine

A

NRTI
(3TC)

BM suppression (reverse w/ G-CSF and EPO)
Lactic acidosis, peripheral neuropathy,
32
Q

Satuvidine

A

NRTI
(d4T)

BM suppression (reverse w/ G-CSF and EPO)
Lactic acidosis, peripheral neuropathy,
33
Q

Tenofovir

A

NRTI
(TDF)

BM suppression (reverse w/ G-CSF and EPO)
Rash, peripheral neuropathy,
34
Q

Zidovudine

A

NRTI
(ZDV)

BM suppression (reverse w/ G-CSF and EPO)
Lactic acidosis, peripheral neuropathy,

Pregnancy/prophylaxis.

Anemia

35
Q

Efavirenz

A

NNRTI

Rash, hepatotoxicity

Vivid dreams and CNS symptoms

not for pregnancy

36
Q

Nevirapine

A

NNRTI

Rash, hepatotoxicity

37
Q

Delavirdine

A

NNRTI

Rash, hepatotoxicity

Not for pregnancy

38
Q

Interferons

A

Glycoproteins. Synthesized in viral infected cells, wide range of antitumor and antiviral properties

Neutropenia and myopathy

39
Q

IFN-a

A

Chronic Hep B, Hep C

Kaposi sarcoma, Hairy cell leukemia, conyloma acuminatum, RCC, MM

40
Q

IFN-B

A

MS

41
Q

IFN-y

A

CGD

Microbio (11 decks)

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