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Antivirals Flashcards

1
Q

HSV/ VZV- correspond to what HHVs

A

1,2,3

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2
Q

First line Tx for HSV, VZV

A

Acylovir, Valacyclovir, Penciclovir, Famicilovir

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3
Q

Alternative Tx for HSV and VZV

A

Cidofovir, Foscarnet, Vidarabine

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4
Q

Acyclovir- Drug class

A

Nucleoside analog of Guanosine

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5
Q

Acyclovir- MOA

A

viral thymidine kinase converts Acyclovir to acylco GMP –> inhibits viral DNA pol, chain termination

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6
Q

Acyclovir- admin

A

Topical, IV, Oral- not absorbed well orally

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7
Q

Acyclovir- elimination

A

renal

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8
Q

Acyclovir MOR

A

viral TK or viral DNA polymerase mutation

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9
Q

Acyclovir t1/2

A

3 hr

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10
Q

Acyclovir AE

A

Acyclovir has poor solubility, ensure adequate hydration to prevent crystalluria

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11
Q

Valcyclovir- Structure

A

Ester of Acyclovir

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12
Q

Valcyclovir advantages

A

Increased water solubility increases bioavailability

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13
Q

Pencicilovir Structure

A

Add OH group to Acyclovir

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14
Q

Penciclovir Advantage

A

increases intracellular concentration, prolonging the intracellular half life

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15
Q

Pencilovir Chain termination

A

Not an obligate chain terminator

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16
Q

Famciclovir Structure

A

Ester of Penciclovir

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17
Q

Famcilovir Advantage

A

More water soluble & Inc half life

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18
Q

Cidofovir structure

A

Nuleotide analog of Cytidine Monophosphate

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19
Q

Cidofovir activation

A

independent of the virus

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20
Q

Cidofovir MOA

A

viral DNA polymerase inhibitor –> chain termination

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21
Q

CIdofovir- Admin

A

IV

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22
Q

Cidofovir elim

A

Renal

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23
Q

Cidofovir- Uses

A

Resistant HHV1,2,3 and CMV (HHV5)

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24
Q

Cidofovir AE

A

dose limiting renal toxicity ensure is pre hydrated with IV saline

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25
Cidofovir + Probenacid
Give probenacid to dec renal elimination of Cidofovir
26
Foscarnet Structure
Pyrophosphate analog
27
Foscarnet MOA
binds to pyrophosphate binding site of viral DNA pol --> inhibits it
28
Foscarnet Admin
IV
29
Foscarnet elim
Renal
30
Foscarnet AE
renal toxicity, prevent via hydration
31
Foscarnet resistance
mutation in viral DNA polymerase
32
Vidarabine Structure
Adenosine analog
33
Vidarabine MOA
viral TK coverts it to Ara- MP --> Ara- ATP inhibits viral DNA pol BUT NOT A CHAIN TERMINATOR
34
VIdarabine MOR
mutation in viral DNA pol
35
Vidarabine uses
Topical treatment for herpes keratitis. Limited systemic value b/c of metabolic inactivation and high toxicity
36
Tx for CMV
Cidofovir, Ganciclovir, Valganciclovir
37
Ganciclovir structure
similar to acyclovir but altered to be an inhibitor of UL97
38
Ganciclovir Admin
IV, not absorbed wel orally
39
Ganciclovir Elim
renal
40
Ganciclovir AE
myelosuppresion that is potentiated when given with Zidovudine (AZT)
41
Gancilovir Resistance
UL97 or DNA polymerase mutation
42
Valgancilovir structure
Ester of Ganciclovir
43
Valganciclovir advantages
Increased bioavailability compared to Ganciclovir
44
HBV Tx
Lamivudine, Adefovir, IFN alpha
45
Lamivudine structure
Cytidine analog
46
Lamivudine MOA
NRTI + chain terminator
47
Lamivudine admin
Oral
48
Lamivudine excretion
renal
49
Lamivudine AE
fairly non toxic
50
Lamivudine resistance
rapid and common
51
Adefovir Structure
AMP nucleotide
52
Adefovir MOA
nucletoide RTI
53
Adefovir use
alternative CMV tx if resistant to lamivudine
54
Adefovir admin
oral
55
Adefovir excretion
Renal, as adefovir
56
Adefovir resistance
None up to 1 yr
57
Adefovir AE
Dose limiting renal toxicity
58
IFN alpha how do you get it
Recombinant protein
59
IFN alpa MOA
immune cytokine that activates non selective immunity (macrophages and NK cells) and stops replication in virally infected cells
60
IFN alpha admin
subcutaneous or IM
61
IFN alpha AE
Feel sick- fever, flu like, injection site reactions. Bone marrow suppression
62
IFN alpha CI
autoimmune disease, hepatic decompensation
63
HCV tx
IFN alpha, Ribavirin
64
IFN alpha in HCV
prophylaxis and chronic infection
65
Ribavirin use only with?
IFN alpha
66
Ribavirin structure
guanidine/ adenosine dual analog
67
Ribarvirin MOA
inserts itself into mRNA and causes hypermutation NOT A CHAIN TERMINATOR
68
Ribavirin admin
oral
69
Ribavirin elim
renal
70
Ribavirin AE
dose limiting renal toxicity b/c stored in RBC for entire 90 day life span
71
Ribavirin CI
Pregnancy
72
Influenza A tx
Amantadie, Rimantadine, Oseltamavir, zanamavir
73
Amantadine MOA
M2 blocker
74
Amantadine uses
only prophylactic and treatment of suspected influenza A infection
75
Amantadine admin
Oral
76
Amantadine elim
renal
77
Amantadine resistance
frequent but strain dependent
78
Amantadine AE
abdominal pain. Crosses BBB and is dopaminergic- agitation, hallucination, cardiac arrhythmias, death if OD
79
Rimantadine MOA
M2 inhibitor
80
Rimantadine uses
prophylaxis and Tx and influenza A infection
81
Rimantadine admin
Oral
82
Rimantadine metabolism
liver
83
Rimantadine excretion
renal
84
Rimantadine resistance
Exists
85
Rimantadine AE
GI, but less BBB penetration than amantadine so less CNS side effects
86
Oseltamavir Name
Tamiflu
87
Oseltanavir MOA
Sialic acid analog that blocks neurominidase for prophylaxis and early tx
88
Oseltanavir admin
Oral
89
Oseltanavir AE
GI toxicity
90
Oseltanavir resistance
high
91
Oseltanavir uses
Influenza A and B
92
Zanamavir MOA
sialic acid analog that blocks neuriminidase for propyxlaxis and early tx
93
Zanamavir admin
Nasal
94
Zanamavir AE
respiratory toxicity- bronchospasm
95
Zanamvir CI
Pulmonary disease
96
Influenza B tx
oseltamavir and zanamavir

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