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Pharm 4 > Antivirals > Flashcards

Antivirals Flashcards

1
Q

NRTI’s

A

Abacavir, Lamivudine, Emtricitibine

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2
Q

NNRTI’s

A

Efavirenz

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3
Q

Nucleotide

A

Tenofovir

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4
Q

HIV Protease inhibitors

A

Ritonavir, Darunavir, Atazanavir

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5
Q

Fusion/Entry/Integration inhibitors

A

Enfuvirtide, Maraviroc, Dolutegravir

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6
Q

Genotype for resistance?

A

RT and Protease

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7
Q

Zidovudine (AZT) - analog

A

Thymidine

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8
Q

NRTI’s - TOX

A

mitochondrial DNA polymerase gamma TOX
Hyperlipidemia/insulin resistance (aidovudine, stavudine)
Lactic acidosis with hepatic steatosis (life threatening, monitor aminotransferase levels)

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9
Q

Abacavir - analog

A

Guanosine

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10
Q

Abacavir - metabolism

A

Deactivated in liver

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11
Q

Abacavir - combo

A

+Lamivudine

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12
Q

Abacavir - TOX

A

MI (caution in CV, platelet adhesion)
HLA-B*5701 hypersensitivty
skin rash

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13
Q

Lamivudine/Emtricitabine - analog

A

L = cytosine analog (Em is fluorinated analog of L, longer half life)

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14
Q

Lamivudine/Emtricitabine - used in?

A

HBV treatment

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15
Q

Truvada

A

Emtricitabine + Tenofovir DF

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16
Q

Tenofovir - analog

A

acyclic nucleotide of adenosine

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17
Q

Tenofovir - drug or prodrug?

A

Prodrug

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18
Q

Truvada - use?

A

First line backbone + chronic hepatitis

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19
Q

Truvada - excrete?

A

Renal

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20
Q

Truvada - TOX

A 
fatigue
weakness
flatulence
renal accumulation (ATN, renal failure, Fanconi's)
osteopenia
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21
Q

Efavirenz - mechanism

A

Allosteric binding to RT, inhibits RNA/DNA polymerase, doesn’t need phosphorylation, not competitive inhibition, not against HIV-2

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22
Q

Efavirenz - in pregnancy?

A

NO

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23
Q

Which HIV drug NOT in pregnancy?

A

Efavirenz

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24
Q

Efavirenz - drug drug rx

A

metabolized by/induces CYP3A4

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25
Q

Efavirenz - TOX

A

nightmares/psych (at start - resolves)

GI, skin, SJS

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26
Q

Protease inhibitors - mechanism

A

peptidomimetics, inhibit proteolytic cleavage of gag and gag-pol, no activation, resistsance common

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27
Q

Protease inhibitors - metabolism

A

metabolized by and inhibits CYP3A4

28
Q

Protease inhibitors - TOX

A

lipodystrophy, increased triglycerides + LDL

29
Q

Ritonavir - administration

A

+food - incr bioavailability

+ other PT - boosted

30
Q

Ritonavir - metabolism

A

inhibits CYP3A4

31
Q

Ritonavir - TOX

A

incr triglycerides + LDL + aminotransferase

32
Q

Lopinavir - combo?

A

only with Ritonavir (R inhibs CYP3A4 - incr Lopinavir)

33
Q

Lopinavir - metabolism

A

hepatic clearance

34
Q

Lopinavir - in pregnancy

A

YES

35
Q

Maraviroc - mechanism

A

inhibits gp120 binding

binds selectively to CCR (1/2)

36
Q

Maraviroc - TOX

A

Hepatic block box

37
Q

Enfuvirtide - mechanism

A

binds to gp41

38
Q

Enfuvirtide - administration

A

sub Q

39
Q

Enfuvirtide - caution

A

only in tx experienced pts

40
Q

Dolutegravir - mechanism

A

inhibits integration (INSTI)

41
Q

PEP

A

Raltegravir + Tenofovir DF + Emtricitabine

42
Q

PrEP

A

Tenofovir DF + Emtricitabine

43
Q

Acyclovir - analog

A

Guanosine analog

44
Q

Acyclovir - mechanism

A

viral thymidine kinase - 1st phosphate

competes with deoxyGTP

45
Q

Acyclovir - target

A

1st line: HSV encephalitis, neonatal HSV, severe HSV/VZV
HSV1/2&raquo_space;VZV
EBV, CMV, HHV-6

46
Q

Acyclovir - uses

A

topical, IV, goes to CSF

47
Q

Acyclovir - clearance

A

Renal

48
Q

Acyclovir - TOX

A

N/V, HA, renal tox (crystals IV), neurotox (tremor, delirium, seizures)
increase fluids

49
Q

Acyclovir - drug drug rx

A

Probenecid/cimetidine increase acyclovir

50
Q

Acyclovir - resistance

A

reversible, TK mutation (use Foscarnet)

51
Q

Ganciclovir - analog

A

acyclic guanosine analog

52
Q

Ganciclovir - target

A

CMV (HSV, VZV, HHV 6/8)

post-transplant

53
Q

Ganciclovir - administration

A

IV, intraocular

54
Q

Gancyclovir - TOX

A

myelosuppresssion, carcinogenic?

55
Q

Foscarnet - analog

A

pyrophosphate analog

56
Q

Foscarnet - mechanism

A

inhibits DNA/RNA polymerase

57
Q

Foscarnet - administration

A

IV only

58
Q

Foscarnet - use

A

good for acyclovir resistance

59
Q

Foscarnet - TOX

A

renal, hyperphosphatemia, hypokalemia/calcemia/magnesemia

60
Q

Oseltamivir / Zanamivir - administration

A

PO / inhalation

61
Q

Oseltamivir / Zanamivir - mechanism

A

neuraminidase inhibitors, don’t let progeny out

62
Q

Oseltamivir / Zanamivir - analog

A

sialic acid analog

63
Q

Oseltamivir - metabolism

A

Requires hepatic activation

64
Q

Oseltamivir / Zanamivir -ages

A

O > 1yr, Z > 7 yrs

65
Q

Amantadine - mechanism

A

NMDA antag (anti-Park), inhibits uncoating

Pharm 4 (5 decks)

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