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Step 1 Pharmacology > Antivirals and other Antimicrobials > Flashcards

Antivirals and other Antimicrobials Flashcards

1
Q

Class: zidovudine

A

Nucleoside RTI

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2
Q

Side effect: zidovudine

A

CNS disturbances: confusion, seizures

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3
Q

Class: lamivudine

A

Nucleoside RTI

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4
Q

Side effect: lamivudine

A

None. Has activity against hepatitis B

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5
Q

Class: emtricitabine

A

Nucleoside RTI

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6
Q

Side effect: emtricitabine

A

None. Has activity against hepatitis B

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7
Q

Class: didanosine

A

Nucleoside RTI

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8
Q

Side effect: didanosine

A

Pancreatitis

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9
Q

Class: zalcitabine

A

Nucleoside RTI

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10
Q

Side effect: zalcitabine

A

Pancreatitis (uncommon), oral ulcers

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11
Q

Class: stavudine

A

Nucleoside RTI

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12
Q

Side effect: stavudine

A

Increased hepatic transaminases, lipoatrophy, hyperlipidemia, lactic acidosis

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13
Q

Class: abacavir

A

Nucleoside RTI

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14
Q

Side effect: abacavir

A

Hypersensitivity reactions in HLA-B5701 (requires screening)

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15
Q

Class: tenofovir

A

NucleoTide RTI

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16
Q

Side effect: tenofovir

A

Renal impairment with hypophosphotemia. Also has activity against hepatitis B.

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17
Q

Nonspecific side effects of NRTI class

A

Peripheral neuropathy, lactic acidosis, fat redistribution (lipodystrophy)

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18
Q

Class: nevirapine

A

NNRTI

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19
Q

Side effect: nevirapine

A

Rash (SJS), elevated LFTs/liver failure

CYP450 inducer–induces it’s own metabolism!

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20
Q

Class: delavirdine

A

NNRTI

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21
Q

Side effect: delavirdine

A

Rash, elevated LFTs

CYP450 INHIBITOR–increases levels of drugs metabolized by CYP450. Inhibits it’s own metabolism!

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22
Q

Class: efavirenz

A

NNRTI

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23
Q

Side effect: efavirenz

A 
CNS disturbances (abnormal dreams, impaired concentration, somnolence)
CYP450 inducer
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24
Q

Class: etravirine

A

NNRTI–effective in persons with resistance to other NNRTIs

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25
Q

Side effect: etravirine

A

Rash (mild)

CYP450 inducer

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26
Q

Class: rilpivirine

A

NNRTI–effective in persons with resistance to other NNRTIs

27
Q

Side effect: rilpivirine

A

Depression, insomnia, headache, rash

CYP450 inducer

28
Q

Problem with resistance to NNRTI’s?

A

Resistance against one drug of this class confers resistance to the majority of them. Etravirine and rilpivirine remain effective in strains with prior NNRTI resistance.

29
Q

General side effects of protease inhibitors?

A

Dyslipidemia, insulin resistance, lipodystrophy

30
Q

Class: saquinavir

A

Protease inhibitor

31
Q

Side effect: saquinavir

A

Poorly absorbed –> GI effects (diarrhea, nausea, dyspepsia, vomiting)
Reformulated as fortovase which has enhanced bioavailability

32
Q

Class: indinavir

A

Protease inhibitor

33
Q

Side effect: indinavir

A

Kidney stones, GI upset (but absorbed well in fasting state)

34
Q

Class: ritonavir

A

Protease inhibitor

35
Q

Side effect: ritonavir

A

GI side effects

Potent CYP450 inhibitor (used to “boost” levels of other drugs which allows less frequent dosing)

36
Q

Class: nelfinavir

A

Protease inhibitor

37
Q

Side effect: nelfinavir

A

Diarrhea

38
Q

Class: amprenavir/fosamprenavir

A

Protease inhibitor

39
Q

Side effect: amprenavir/fosamprenavir

A

GI upset, rash, paresthesias

40
Q

Class: lopinavir

A

Protase inhibitor. Coformulated with ritonavir as combivir.

41
Q

Side effect: lopinavir/combivir

A

Mild GI. Well tolerated.

Used during pregnancy.

42
Q

Class: atazanavir

A

Protease inhibitor

43
Q

Side effect: atazanavir

A

Indirect bilirubinemia without jaundice. Less impact on lipids. Cannot be taken with PPIs.

44
Q

Class: tipranavir

A

Protease inhibitor

45
Q

Side effect: tipranavir

A

GI upset. Coadministered with ritonavir for boosting.

46
Q

Class: darunavir

A

Protease inhibitor–effective in patients with resistance to other PI’s

47
Q

Side effect: darunavir

A

GI upset. Once daily dosing.

48
Q

Class: enfuvirtide

A

Fusion inhibitor (binds p41 of envelope)

49
Q

Side effect: enfuvirtide

A

Injection site reactions, neutropenia

“Salvage regimen”

50
Q

Class: maraviroc

A

CCR5 inhibitor

51
Q

Side effect: maraviroc

A

Well tolerated

52
Q

Class: raltegravir

A

Integrase inhibitor

53
Q

Side effect: raltegravir

A

Diarrhea, nausea, fatigue

54
Q

Class: elvitegravir

A

Integrase inhibitor

55
Q

Side effect: elvitegravir

A

Diarrhea, nausea, proteinuria

Administered in combination with emtricitabine, tenofovir, and cobicistat (CYP450 inhibitor), called Stribild

56
Q

MOA: amantadine, rimantadine

A

Inhibits viral genome uncoating of influenza A only

57
Q

Class: oseltamivir, zanamivir, peramivir

A

Neuraminidase inhibitors

58
Q

Clinical use of ribavirin?

A

RSV in infants, Lassa fever (arenaviridae), hantavirus pulmonary syndrome, HCV (in combination with interferon)

59
Q

Clinical use of interferon?

A

Treatment of chronic hepatitis B and hepatitis C in combination with ribavirin

60
Q

MOA: boceprevir/telaprevir

A

Hepatitis C protease NS3-4A inhibitors.

Used in combination with interferon and ribavirin

61
Q

Class: acyclovir/famciclovir/valacyclovir

A

Guanosine analogue, requires phosphorylation by HERPES thymidine kinase

62
Q

Class: ganciclovir

A

Guanosine analogue, requires phosphorylation by HUMAN thymidine kinase

63
Q

Class: cidofovir

A

Cytosine analogue, requires phosphorylation by HUMAN cellular kinases

64
Q

Class: foscarnet

A

Pyrophosphate analogue which inhibit viral DNA polymerase/reverse transcriptase

Step 1 Pharmacology (4 decks)

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