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GI II > Antivirals I > Flashcards

Antivirals I Flashcards

1
Q

What are the main anti-HSV and anti-VSV agents?

A

Acyclovir, Famciclovir, and Valacyclovir. All guanosine analogs.

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2
Q

What is the mechanism of action of the guanosine analogs?

A

They inhibit DNA polymerase and incorporate into viral DNA.

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3
Q

What are the other anti-HSV and anti-VSV agents?

A

Docosanol and Trifluridine.

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4
Q

What is Docosanol?

A

A 22 carbon alcohol that inhibits fusion of the viral envelop with the host cell membrane.

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5
Q

What is Trifluridine?

A

A fluorinated nucleoside that prevents both viral and host DNA synthesis.

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6
Q

What is Trifluridine used for?

A

Acyclovir resistant HSV.

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7
Q

What are the anti-CMV agents?

A

Ganciclovir, Valganciclovir, Cidofovir, and Foscarnet.

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8
Q

What is Cidofovir?

A

A cytosine analog. It’s di-phosphorylation is independent of viral kinases.

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9
Q

What is the drug of choice for CMV and why?

A

Valganciclovir, because it is orally active.

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10
Q

What is the treatment for HBV comprised of?

A

Five oral nucleoside/nucleotide analogs that are inhibitors of HBV DNA polymerase.

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11
Q

What is the treatment regimen for HBV?

A

HBV is treated sequentially (as opposed to HCV which responds best to combination therapy).

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12
Q

What are the anti-HBV agents?

A

Entecavir, Tenofovir, Adefovir, Lamivudine, and Telbivudine.

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13
Q

What is Entecavir?

A

A guanosine analog.

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14
Q

What is the best anti-HBV agent and its contraindication?

A

Tenofovir is the best anti-HBV agent, but it is contraindicated in renal insufficiency.

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15
Q

What else can be used used anywhere in the HBV treatment sequence?

A

PEG-IFN.

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16
Q

What were the only anti-HCV agents before the direct acting agents were discovered?

A

PEG-IFN and Ribavirin.

17
Q

What is Ribavirin?

A

A guanosine analog that interferes with RNA metabolism required for viral replication. It works via multiple mechanisms.

18
Q

What is the MOA of IFN?

A

Inhibits RNA and protein synthesis and destroys both the virus and infected host cells (a major side effect).

19
Q

What is PEP?

A

Polyethylene glycol. It increases the half-life of IFN to one injection per week rather than daily.

20
Q

What are the direct acting anti-HCV agents?

A

Drugs ending with the suffixes “buvir”, “previr”, or “asvir”.

21
Q

What is NS3/4 A?

A

A HCV serine protease that catalyzes the cleavage of the HCV polyprotein into mature HSV. Is targeted by the “previr” drugs.

22
Q

What is NS5B?

A

A HCV RNA dependent RNA polymerase. Is targeted by “buvir” drugs.

23
Q

What is NS5A?

A

A HCV replicase. It is inhibited by the “asvir” drugs.

24
Q

What is the MOA of drugs ending in “buvir”?

A

They target HCV NS5B.

25
Q

What is the MOA of drugs ending in “previr”?

A

They target HCV NS3/4 A.

26
Q

What is the MOA of drugs ending in “asvir”?

A

They target HCV NS5A.

27
Q

What is the most common drug combination for HCV?

A

Ledipasvir and Sofosbuvir.

28
Q

What are the anti-influenza agents?

A

The Adamantanes and Neuraminadase inhibitors.

29
Q

What are the Adamantanes?

A

Amantadine and Rimentadine.

30
Q

What is the MOA of the Adamantanes?

A

They block viral release by targeting the M2 protein.

31
Q

What are the Adamantenes ineffective against?

A

H1N1, H3N2, and all influenza B strains.

32
Q

What are the Neuraminadase inhibitors?

A

Zanamir (inhalation), Oseltamivir, and IV Peramiver.

33
Q

What is the MOA of Neuraminadase inhibitors?

A

They block viral release.

34
Q

What is an adverse side effect of IFN as well as a contraindication?

A

IFN can cause autoimmune reactions and is contraindicated in hyperbilirubinemia due to hepatic damage.

GI II (7 decks)

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