antivirals & movement disorders Flashcards
acyclovir MOA
missing OH group
herpes can’t tell difference and mistakes it for DGTP and results in chain termination. This blocks nucleic acid synthesis
Acyclovir uses and side effects
fist anti herpes drug approved
HSV1
HSV2
VZV
good for pregnancy to reduce viral shedding and C-section rate.
Renal insufficiency d/t drug crystallizing
azidothymidine (AZT)
Primary drug cocktail for HIV infections
inhibitor of reverse transcriptase
-used in HAART therapy
Lamivudine
part of HAART inhibitor HBV DNA polymerase and HIV reverse transcriptase
Cabotegrovir
PREP- stops virus from getting into the cell
Interferon (INF)
Suicide note
slows down viral replication and activates MHC receptors on the cell surface. These receptors target CD8 cells (killer T cells). When CD8 cells are activated they fire cytokines directly at the infected cell to kill it.
what are the differences in the flu subtypes?
the subtypes are determined by the human antigen: hemagglutinin(H1,H2,H3) and neuraminidase (N1,N2)
What does Tamiflu target?
Neuraminidase
What does Relenza target?
Neuraminidase
What does Xofluza target?
Polymerase enzyme
(the enzyme responsible for replicating the virus)
what are the 3 flu drugs?
Tamiflu
Relenza
Xofluza
Which drug should you take before you get flu symptoms?
Relenza
what are the FDA approved Covid-19 drugs?
- Paxlovid(experimental med. 2antivirals. Emergency use authorization)
- Remdesivir (chain terminator)
- Mabs (block COVID entry into cells)
- Dexamethasone (targets cytokine storm and inflammation but doesn’t treat the virus)
What is levodopa
a prodrug that crosses the BBB and is converted into dopamine.
only 1-3% actually does cross the BBB so given with carbidopa to increase absorption
MOA of carbidopa?
prevents COMT enzyme from breaking down dopamine
Side effects of Levodopa
hallucinations/delusions.
Give Primavanserin (Nuplazid) to treat.
MOA of Primavanserin (Nuplazid)
inverse agonist at 5HT 2a in the visual cortex.
Visual cortex interacts with the thalamus and substantia nigra which is causing these hallucinations.
used to help with the side effects of levodopa
MOA of Pramipexole
mimics dopamine at the dopamine receptors
used in parkinsons
which class of drugs and drug specifically inhibit the reuptake of dopamine?
MAO-B
(Selegeline)
used in parkinsons
COMT inhibitors we need to know:
Tolcapone
used in parkinsons
what is apomorphine?
derivative of morphine. Doesn’t have the same effects as morphine but is a dopamine agonist
used in parkinsons
what is baclofen?
a muscle relaxant used in cerebral palsy via a pump
what is MOA of tetrabenazine and which disease/disorder is it used for?
Depletes dopamine
huntington’s disease
only has an effect on the movement part of the disorder, not the dementia part.
Patho of huntington’s disease
genetic disease where the huntingtin protein is produced by chromosome 4. Produces progressive loss of muscle control in people 30-40y/o.
Normal: Dopamine affects GABA neuron and GABA is released.
Huntington’s:
Dopamine is normal but GABA neuron is reduced in the basal ganglia. Now you have too much dopamine. Treat with dopamine blocker
How does haloperidol help Huntington’s disease?
it is a dopamine receptor blocker
What drugs are used for ALS (Lou Gherig’s)
Riluzole: sodium channel blocker that specifically targets damaged neurons. That blocks the release of ACh in misfiring neurons.
What is Tacrine used for? MOA?
Alzheimer’s disease
CNS ACh esterase inhibitor
What is Memantine used for? MOA?
Alzheimer’s disease
NMDAr antagonist (basis for memory fomation)
