Antivirals Flashcards
mechanism of oseltamivir
influenza neuraminidase inhibitor which presents release of viral progeny from host cell
need to use oseltamivir in the first _____ hrs
48
mechanism of acyclovir
guanosine analogue that is phosphorylated by HSV/VZV thymidine kinase in infected cells –> inhibits viral DNA polymerase by chain termination
clinical use of acyclovir
HSV, VZV
valcyclovir
prodrug of acyclovir that has better oral bioavailability
famciclovir
form of acyclovir used for HZV (shingles)
SEs of acyclovir, valcyclovir, famciclovir
crystalline nephropathy and ARF if not adequately hydrated
mechanism of ganciclovir
guanosine analoque that is phosphorylated by CMV viral kinase in infected cells and inhibits viral DNA polymerase
clinical use of ganciclovir
CMV
valganciclovir
prodrug of ganciclovir with better bioavailability
SEs of ganciclovir, valganciclovir
BM suppression, nephrotoxicity
mechanism of foscarnet
pyrophosphate analogue that inhibits viral DNA/RNA polymerase as well as HIV reverse transcriptase, does not require phosphorylation for activation
clinical use of foscarnet
resistant HSV and CMV
SEs of foscarnet
nephrotoxicity –> electrolyte abnls –> seizures
mechanism of cidofovir
inhibition of viral DNA polymerase, does not require phosphorylation
clinical use of cidofovir
resistant HSV and CMV
SEs of cidofovir
nephrotoxicity (give with IV saline and probenecid)
mechanism of maraviroc
binds CCR5 on monocyte surface preventing interaction with viral gp120 –> prevents viral docking on host cells
mechanism of enfuvirtide
ginds gp41 on virus to prevent viral fusion with host cell membrane
abacavir, tenofovir, -ine antiHIV meds
NRTIs
mechanism of NRTIs (abacavir, tenofovir, -ine)
competitively inhibit nucleotide binding to RT and terminate DNA chain (lack 3’ OH)
Which NRTI used for ppx and during pregnancy to prevent vertical transmission?
zidovudine
Which NRTI is associated with hypersensitivity? Via wihch HLA?
abacavir, HLA-B5701
Which NRTI associated with pancreatitis?
didanosine
SEs of NRTIs
BM suppression, peripheral neuropathy, lactic acidosis, lipodystrophy
Which NRTI associated with anemia?
zidovudine
mechanism of -vir- antiHIV drugs
NNRTIs - bind to and inhibit RT but not at active site
SEs of -vir- antiHIV drugs
SJS, hepatotoxicity
Which NNRTI is associated with vivid dreams and neuropsych symptoms?
efavirenze
mechanism of -navir drugs
protease inhibitors - prevents cleavage of HIV mRNA products into their functional parts, so prevents maturation of new virus progeny
SEs of -navir drugs
insulin resistance, lipodystrophy
mechanism of -tegravir drugs
reversible integrase inhibitors - prevents HIV genome integration into host cell chromosome
SEs of -tegravir drugs
myopathy
mechanism of interferons
glycoproteins normally synthesized by virus-infected cells to facilitate their destruction
clinical use of IFNa
HBV, HCV, condyloma acuminata, Kaposi sarcoma, hairy cell leukemia, RCC, melignant melanoma
clinical use of IFNb
MS
clinical use of IFNy
CGD
SEs of IFNs
flu-like symptoms, neutropenia, myopathy
mechanism of ribavirin in HCV
competitive inhibition of inosine monophosphate dehydrogenase which inhibits synthesis of guanine nucleotides
mechanism of sofosbuvir
inhibits HCV RNA polymerase, chain termination
mechanism of simeprevir
HCV protease inhibitor