Antivirals Flashcards
acyclovir trade name
- zovirax
acyclovir analogue of
- deoxyguanosine
acyclovir action
- chain terminator of viral DNA synthesis
acyclovir specificity
- HSV infected cell
- viral DNA
how acyclovir gets into cell
- unphosphorylated
how acyclovir becomes active
- phosphorylation
initial step of phosphorylation accomplished by
- HSV thymidine kinase
- only in cells with HSV do you get the first phosphorylation
acyclovir affinity
result?
- greater for viral polymerase than cellular polymerase
- less cellular toxicity
acyclovir very affective against
- HSV-1 and 2
acyclovir drug of choice for
- HSV and VZV
acyclovir activity against other herpesviruses
- little to no in vivo activity
problem with oral acyclovir
- not high bioavailability
acyclovir options for teens and adults
- valacyclovir
- famciclovir
type of drug for valacyclovir and famciclovir
- pro drug of acyclovir
valacyclovir and famciclovir used for
- treatment or prophylaxis
for really serious infections against herpes virus family
- give IV acyclovir
by the end of the day of a coldsore, you are seeing
- the inflammatory response
- little viral replication
ganciclovir phosphorylated by
result?
- CMV kinase
- cellular kinases
- less specific
ganciclovir MOA
- inhibits CMV replication
ganciclovir adverse effects
- greater
- bone marrow toxicity
ganciclovir use
- severe CMV infection
- HHV-6, HSV and VZV
valganciclovir type of drug
- pro drug of ganciclovir
valganciclovir use
- oral prophylaxis
- preemptive therapy
herpesvirus DNA polymerase inhibitors examples
- foscarnet
- cidofovir
foscarnet and cidofovir effects
- nephrotoxicity
antiviral resistance mostly due to mutations in
- viral thymidine kinase
- viral polymerase
antiviral resistance usually seen in
why?
- immunocompromised patients
- much higher viral load, more antiviral agents, more changes for mutation
segmented genome viruses
- flu
- rotavirus
antiviral drugs for influenza
- amantidine (symmetrel
- rimantadine (flumadine)
- OSTELTAMIVIR (TAMIFLU)
- zanamivir (relenza)
osteltamivir (tamiflu) and zanamivir (relenza) inhibit
- neuraminidase
osteltamivir (tamiflu) and zanamivir (relenza) effective for which types of flu
- A and B
how to take zanamivir
- inhaled
problem with antiviral drugs for influenza
- development of resistance
adverse events of antiviral drugs for influenza
- neuropsychiatric effects
- insomnia, “child bouncing off wall”
function of neuraminidase
- cleaves sialic acid attached to flu virus as it tries to leave the cell
if you start tamiflu on the day that you are ill with influenza
- you may have one day less with symptoms
ribavirin type of drug
- nucleoside analog
ribavirin historically used for
- aerosol treatment of patients with RSV
ribavirin currently used for
- combination therapy for Hep C
ribavirin adverse effect
- anemia
NRTI drugs
- Zidovudine
- Abacavir
- Lamivudine
- Emtricitabine
- Tenofovir
NRTI ZALET (SALAD)
Zidovudine trade name
- Retrovir
- AZT
Zidovudine type of drug
- analog of thymidine
- DNA chain elongation terminator
Zidovudine MOA
- competitive binding of RT
Zidovudine fun fact
- only drug available in IV formation
Zidovudine serious effects
- black box warnings for neutropenia
- severe anema
- myopathy
Abacavir trade name
- Ziagen
Abacavir use compared to zidovudine
- greater use than zidovudine
Abacavir risk
- risk of hypersensitivity reaction
Abacavir serious effects
- cardiac disease
Lamivudine trade name
- Epivivr
Emtricitabine trade name
- Emtriva
Lamivudine and Emtricitabine common use with
- zidovudine or tenofovir
Lamivudine and Emtricitabine also effective for
- Hep B
Tenofovir trade name
- Viread
Tenofovir commonality
- most common drugs in combination pills
- drug most in use
TAF vs TDF
- TAF less renal and bone toxicity than TDF
Tenofovir also effective against
- Hep B
Lopinavir/Ritonavir trade name
- Kaletra
Lopinavir/Ritonavir MOA
- protease inhibitor
- navir - is a protease inhibitor
use of ritonavir
- to boost primary drug
Raltegravir MOA
- integrase inhibitor
Maraviroc MOA
- inhibitor CCR5 coreceptor
