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Pharmacology > Antivirals for non-HIV > Flashcards

Antivirals for non-HIV Flashcards

1
Q

Biosynthesis of a toxin from a non-toxic precursor
Common in nucleoside analogues that must phosphorylated to incorporate into viral DNA

A

Lethal synthesis

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2
Q

MOA of acyclovir and valacyclovir

A

Inhibit viral DNA synthesis through lethal synthesis
Drugs are monophosphates; host enzymes convert them to inhibitive triphosphates that terminate viral DNA synthesis

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3
Q

Acyclovir and valacyclovir lethal synthesis requires these 2 types of enzymes

A

Viral nucleoside kinase expression to phosphorylate drug (monophosphate)
Host enzymes to convert monophosphate to triphosphate form

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4
Q

Valacyclovir is converted to this in a first pass hydrolysis reaction

A

Acyclovir

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5
Q

This is converted to acyclovir in a first pass hydrolysis reaction

A

Valacyclovir

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6
Q

2 indications for acyclovir and valacyclovir

A

Herpes infections
Cytomegalovirus infections

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7
Q

3 main adverse effects of acyclovir and valacyclovir

A

Reversible renal dysfunction (crystallization of drug in renal tubule and collecting duct)
Neurological and renal toxicity with high dose or IV infusion
Thrombocytopenia purpura-hemolytic uremic syndrome (potentially fatal; most frequent in immunocompromised patients)

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8
Q

Reversible renal dysfunction, neurological and renal toxicity with high dose or IV infusion, and thrombocytopenia purpura-hemolytic uremic syndrome are adverse effects of these drugs

A

Acyclovir and valacyclovir

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9
Q

Thrombocytopenic purpura-hemolytic uremic syndrome is a potentially fatal adverse effect of these drugs
Is most frequent in immunocompromised patients

A

Acyclovir and valacyclovir

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10
Q

MOA of cidofovir

A

Lethal synthesis to activated cidofovir diphosphate (requires only host enzymes)
Cidofovir diphosphate incorporated into DNA slows or stops DNA pol activity

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11
Q

Drug that given concurrently reduces cidofovir toxicity

A

Probenecid
Blocks anion transporter on renal tubular epithelial cells that mediates cidofovir uptake

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12
Q

Probenecid given concurrently reduces the toxicity of this drug

A

Cidofovir

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13
Q

Black box warning of Cidofovir

A

Nephrotoxicity

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14
Q

MOA of Foscarnet

A

Competitive inhibitor of viral DNA polymerase
NO lethal synthesis required

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15
Q

2 adverse effects (black box warnings) of Foscarnet

A

Renal toxicity
CNS disturbances (including seizures)

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16
Q

Drug with renal toxicity as an adverse effect; should avoid concurrent use with other nephrotoxic drugs
Electrolyte disturbances in acute overdosage

A

Foscarnet

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17
Q

With foscarnet, concurrent use with these should be avoided

A

Other nephrotoxic drugs

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18
Q

These can occur in acute overdosage of foscarnet

A

Electrolyte disturbances

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19
Q

3 adverse effects of Ganciclovir and Valganciclovir

A

Acyclovir-like adverse reactions (renal dysfunction, neurological toxicity, thrombocytopenic purpura-hemolytic uremic syndrome)
Bone marrow suppression
Teratogenic, mutagenic, and oncogenic potential

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20
Q

4 black box warnings of Ganciclovir and Valganciclovir

A

Hematological toxicities
Carcinogenic and teratogenic activity
Aspermatogenesis
Appropriate oral and IV use only (ganciclovir only)

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21
Q

Hematological toxicities, Carcinogenic and teratogenic activity, Aspermatogenesis, and Appropriate oral and IV use only are black box warnings for these

A

Ganciclovir and Valganciclovir

22
Q

Bone marrow suppression and teratogenic, mutagenic, and oncogenic potential are characteristic adverse effects of these

A

Ganciclovir and Valganciclovir

23
Q

Aspermatogenesis is one of the black box warnings for these drugs

A

Ganciclovir and Valganciclovir

24
Q

Acyclovir, Cidofovir, Foscarnet, Ganciclovir, Penciclovir, Famciclovir, and Trifluridine are drugs used for these infections

A

Herpes and cytomegaloinfections (DNA viruses)

25
Q

Zanamivir, Oseltamivir, Amantadine, Rimantadine and Ribavirin are drugs used for these infections

A

Respiratory viral infections (RNA viruses)

26
Q

MOA of Zanamivir and Oseltamivir

A

Inhibit influenza A and B virus neuraminidase

27
Q

What is the function of viral neuraminidase?

A

Allows the virus to break free from the host cell to infect other cells

28
Q

Does this describe Zanamivir or Peramivir:
Administered by inhalation or by nasal spray
Adverse effects similar to the symptoms of influenza
For patients >7 years
Can be used for prophylaxis

A

Zanamivir

29
Q

Does this describe Zanamivir or Peramivir:
Administered IV, single dose over 15-30 minutes
For patients >2 years
Data for influenza B is limited
Not for prophylaxis

A

Peramivir

30
Q

Oseltamivir (Tamiflu) is a prodrug that is activated by these

A

Esterases in GI tract or liver

31
Q

Oral prodrug for RNA viruses that is activated by esterases in GI tract of liver

A

Oseltamivir (Tamiflu)

32
Q

Drug with low incidence of self-injury, hallucinations and delirium reports, especially in children
Is under consideration for black box warning by FDA

A

Oseltamivir (Tamiflu)

33
Q

Oseltamivir (Tamiflu) is under consideration for black box warning by FDA for these side effects

A

Low incidence of self-injury, hallucinations and delirium reports, especially in children

34
Q

MOA of Ribavirin

A

Converted to monophosphate, diphosphate, and triphosphate forms
Monophosphate form inhibits guanosine triphosphate synthesis to block viral mRNA processing and influenza virus RNA pol

35
Q

2 routes of administration of Ribavirin

A

Oral or IV

36
Q

Drug for RNA viruses whose monophosphate form inhibits guanosine triphosphate synthesis to block viral mRNA processing and influenza virus RNA pol

A

Ribavirin

37
Q

Hemolytic anemia risk in Ribavirin is increased when used with this

A

Interferon alfa

38
Q

Ribavirin is contraindicated in these two groups

A

In pregnant women and male partners of pregnant women (due to mutagenic, teratogenic, and embryotoxic)
In patients with sickle cell anemia (high risk of anemia)

39
Q

Dose dependent hemolytic anemia and mutagenic, teratogenic, and embryotoxic describes this drug for RNA viruses

A

Ribavirin

40
Q

3 black box warnings of Ribavirin

A

Not recommended for monotherapy
Hemolytic anemia
Teratogenic and embryocidal (contraindicated in pregnant women, women who might be pregnant, and their male partners; two forms of birth control recommended for up to 6 months following treatment)

41
Q

Hemolytic anemia is a characteristic adverse effect of this drug

A

Ribavirin

42
Q

Interferon alfa + Ribavirin is used for these infections

A

Hep C viral infections

43
Q

3 drugs that make the combo drug Vosevi

A

Sofosbuvir
Velpatasvir
Voxilaprevir

44
Q

Component of the combo drug Vosevi that Prevents Hep C viral replication by inhibiting NS5B RNA polymerase

A

Sofosbuvir

45
Q

Sofosbuvir prevents Hep C viral replication by doing this

A

Inhibiting NS5B RNA polymerase

46
Q

Component of the combo drug Vosevi that Prevents Hep C viral replication by inhibiting NS5A protein essential for viral function

A

Velpatasvir

47
Q

Component of the combo drug Vosevi that Prevents Hep C viral replication by blocking proteolytic activity of NS3/4A protease, needed for posttranslational processing of viral component proteins

A

Voxilaprevir

48
Q

Velpatasvir prevents Hep C viral replication by doing this

A

Inhibiting NS5A protein essential for viral function

49
Q

Voxilaprevir prevents Hep C viral replication by doing this

A

Blocking proteolytic activity of NS3/4A protease, needed for posttranslational processing of viral component proteins

50
Q

Common adverse effects of Hep C drugs

A

Headache, fatigue, nausea, and diarrhea

51
Q

Drug where hypertension is a typical sign of emerging nephrotoxicity and should be carefully monitored

A

Foscarnet

Pharmacology (14 decks)

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