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Infectious Disease > Antivirals Shuffled > Flashcards

Antivirals Shuffled Flashcards

1
Q

How and when is zanamivir administered?

A

oral inhalation within the first two days of infection

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2
Q

Cobicistat increases the activity of HIV protease inhibitors in what two ways?

A
  • it increases absorption by inhibiting intestinal efflux transporters
  • it inhibits CYP3A4
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3
Q

What hepatitis treatment is recommended for pregnant women?

A

lamivudine

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4
Q

Nucleoside reverse transcriptase inhibitors inhibit what aspect of HIV infection?

A

they inhibit stable infection of new cells

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5
Q

Many HIV drugs have what adverse side effect?

A

they induce and/or inhibit CYP3A4

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6
Q

What is the mechanism of action of simeprevir?

A

it is an HCV protease inhibitor like telaprevir

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7
Q

What is the advantage of using darunavir?

A

it continues to work after HIV becomes resistant to other PIs

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8
Q

What is the mechanism of action of rimantadine?

A

it blocks the M2 proton channel and prevents viral uncoating

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9
Q

How is abacavir metabolized?

A

by alcohol dehydrogenase

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10
Q

How is nevirapine used in clinic?

A

as a single dose therapy to prevent transmission during childbirth

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11
Q

List five drugs used to treat hepatitis.

A
  • interferon alpha
  • lamivudine
  • telaprevir
  • simeprevir
  • sofosbuvir
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12
Q

What is the mechanism of action of cidofovir?

A

it is a cytosine anti-metabolite

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13
Q

What is the mechanism of action of abacavir?

A

it is a guanosine analog and NRTI

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14
Q

Describe the selectivity of tenofovir.

A

it has limited selectivity because it is a monophosphate and therefore has no kinase specificity

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15
Q

What is the adverse effect of efavirenz?

A

although it has little CNS penetration, it is highly toxic there, causing dizziness, drowsiness, nightmares, and amnesia

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16
Q

What is the mechanism of action of ribavirin?

A

it is an anti-metabolite that blocks GTP formation, inhibits viral mRNA capping, and inhibits viral RNA-dependent polymerase

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17
Q

What is acyclovir used to treat?

A

HSV-1 and HSV-2

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18
Q

What are the adverse effects of darunavir?

A

lipodystrophy and metabolic syndrome

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19
Q

Why is enfuvirtide rarely used?

A

because it causes an injection site reaction in most patients and has a half life of only 4 hours, so it requires lots of injections

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20
Q

How is trifluridine used?

A
  • limited selectivity restricts it to topical use

- best for HSV conjunctivitis or epithelial keratitis

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21
Q

What is oseltamivir used to treat?

A

influenza

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22
Q

How does HIV become maraviroc-resistant?

A

it takes on a CXCR4 tropism or the host has a CCR5 mutation

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23
Q

How is the effect of telaprevir enhanced?

A

by taking it with a fatty meal

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24
Q

What is the mechanism of action of maraviroc?

A

it is an HIV binding inhibitor that interferes with the gp120-CCR5 interaction

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25
Q

What is the mechanism of action of dolutegravir?

A

it is an HIV integrase inhibitor

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26
Q

What is special about the pharmacokinetics of oseltamivir?

A

it is given as a prodrug that must be activated in the gut and liver

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27
Q

How and when is rimantadine given?

A

orally within the first 48 hours of exposure

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28
Q

What benefit does lamivudine offer to those with HBV?

A
  • management of their infection

- reduced risk of HCC

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29
Q

List five drugs used to treat herpes by inhibiting viral genome replication.

A
  • acyclovir
  • ganciclovir
  • foscarnet
  • cidofovir
  • trifluridine
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30
Q

What is emtricitabine?

A

a fluorinated form of lamivudine

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31
Q

List the three important anti-influenza medications.

A
  • rimantidine
  • oseltamivir
  • zanamivir
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32
Q

Describe the selectivity of trifluridine.

A

it has very low specificity, activated by hosts kinases and low polymerase specificity

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33
Q

What is the primary adverse effect of foscarnet and how do we deal with it?

A

it is potentially nephrotoxic, so use a saline preload

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34
Q

Oseltamivir is also known as what?

A

tamiflu

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35
Q

What is the advantage of using atazanavir compared to other HIV PIs?

A

it has no associated lipodystrophy or metabolic syndrome

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36
Q

What is the mechanism of action of enfuvirtide?

A

it binds gp41 and serves as a fusion inhibitor

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37
Q

What is rimantadine used to treat?

A

influenza A

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38
Q

What is alafenamide?

A

a form of tenofovir with less renal toxicity and bone loss

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39
Q

What is the mechanism of action for nevirapine?

A

it is a non-competitive inhibitor of HIV RT

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40
Q

What are the benefits of dolutegravir over other HIV integrase inhibitors?

A

resistance develops more slowly and there is less hepatotoxicity

41
Q

What is the mechanism of action of zanamivir?

A

it blocks neuraminidase

42
Q

What is ganciclovir used to treat?

A

retinitis and visceral effects of CMV

43
Q

What is the mechanism of action of darunavir?

A

it is an HIV protease inhibitor

44
Q

What are the adverse effects of interferon alpha?

A
  • may induce autoantibodies

- flu-like syndrome

45
Q

Darunavir is often given alongside what other drug?

A

cobistat

46
Q

Name two CYP3A4 inhibitors used to enhance the bioavailability of HIV protease inhibitors.

A
  • cobicistat

- ritonavir

47
Q

How is telaprevir metabolized?

A

via CYP3A4 and Pgp

48
Q

Anti-HIV agents fall into what six categories?

A
  • binding inhibitors
  • fusion inhibitors
  • integrase inhibitors
  • nucleoside RT inhibitors
  • non-nucleoside RT inhibitors
  • protease inhibitors
49
Q

What is interferon-alpha used to treat?

A
  • HBV management

- HCV eradication (with ribavirin)

50
Q

What polymorphisms affects the effect of simeprevir?

A

Asians have 3x higher bioavailability

51
Q

How is cidofovir cleared from the body?

A

active tubular secretion

52
Q

How does the selectivity of ganciclovir compare to that of acyclovir?

A

it is less kinase and polymerase specific than acyclovir

53
Q

Describe the selectivity of cidofovir?

A

it has no kinase specificity, just polymerase specificity

54
Q

Cidofovir has what adverse effect?

A

dose-dependent nephrotoxicity

55
Q

What is the mechanism of action for tenofovir?

A

it is a chain terminating NRTI

56
Q

How well tolerated is acyclovir?

A

very well given its high selectivity

57
Q

Which five nucleoside RT inhibitors are effective against HIV?

A
  • zidovudine
  • lamivudine
  • emtricitabine
  • abacavir
  • tenofovir
58
Q

What drug combination is used for HCV eradication?

A

12-24 week course of

  • interferon alpha
  • ribavirin
  • sofosbuvir
59
Q

What is the mechanism of action of trifluridine.

A

it competes with TTP for viral polymerase

60
Q

What is the mechanism of action of lamivudine?

A

it is a cytosine analog that inhibits HIV RT and HBV DNA polymerase

61
Q

What is the mechanism of action of raltegravir?

A

it is an HIV integrase inhibitor

62
Q

Cidofovir is usually given alongside what other drug?

A

probenecid to increase bioavailability

63
Q

What is the mechanism of action of zidovudine?

A
  • a thymidine analog and chain terminator

- nucleoside RT inhibitor

64
Q

What are the disadvantages of raltegravir?

A
  • resistance develops quickly

- can’t take with cations or other buffered drugs

65
Q

What is the mechanism of action of efavirenz?

A

it is a NNRTI for HIV

66
Q

What is the mechanism of action of indinavir?

A

it is an HIV protease inhibitor

67
Q

What are the adverse effects of ribavirin?

A
  • known teratogen and embryotoxin

- may cause a dose-dependent anemia

68
Q

How is efavirenz taken to increase bioavailability?

A

take it on an empty stomach

69
Q

What is the mechanism of atazanavir?

A

it is an HIV protease inhibitor

70
Q

Tenofovir is part of what HIV regimen?

A

PReP

71
Q

What are the disadvantages of nevirapine?

A
  • inducer of CYP3A4
  • resistance emerges quickly
  • causes a skin rash
72
Q

Which viruses are resistant to acyclovir?

A

those that are without thymidine kinase

73
Q

What is the mechanism of efavirenz?

A

it is an HIV NNRTI

74
Q

What is zanamivir used to treat?

A

influenza A and B

75
Q

When is cobicistat contraindicated?

A

when patients have a GFR less than 30

76
Q

How is the bioavailability of interferon-alpha improved?

A

using a pegylated formulation

77
Q

What are the adverse effects of indinavir?

A

it causes hyperbilirubinemia and nephrolithiasis

78
Q

What is the mechanism of action of foscarnet?

A

it is a pyrophosphate anti-metabolite which directly inhibits viral polymerase to prevent viral genome replication

79
Q

What are the indications for ribavirin?

A
  • orally and with INFa for HepC

- as an aerosol for respiratory syncytial virus

80
Q

What are the two adverse effects of simeprevir?

A
  • photosensitivity rash

- sulfa moiety that causes Steven-Johnson syndrome

81
Q

What is the most significant adverse effect of abacavir?

A

a severe hypersensitivity reaction predicted by HLA-B5701

82
Q

What is foscarnet used to treat?

A
  • synergistic with ganciclovir for CMV

- used for valcyclovir-resistant herpes simplex

83
Q

How does resistance to zidovudine develop?

A

through RT mutations

84
Q

What is the mechanism of action of telaprevir?

A

it is an HCV protease inhibitor

85
Q

What is responsible for the selectivity of ribavirin?

A
  • it has no kinase selectivity

- it has a selectivity for viral polymerase

86
Q

What is the mechanism of action of oseltamivir?

A

it blocks neuraminidase

87
Q

What is cidofovir used to treat?

A

herpes simplex and CMV

88
Q

What are the adverse effects of maraviroc?

A
  • hepatotoxicity preceded by an allergic reaction

- cough, myalgia, diarrhea

89
Q

What is the mechanism of action of sofosbuvir?

A

it inhibits HCV RNA polymerase

90
Q

Lamivudine is used in the treatment of which two conditions?

A

HBV and HIV management

91
Q

What are the two forms of tenofovir?

A
  • alafenamide

- disoproxil

92
Q

What is cobicistat?

A

a CYP3A4 inhibitor used to extend the bioavailability of HIV protease inhibitors

93
Q

What is the mechanism of action of ganciclovir?

A

it is a guanosine analog anti-metabolite which inhibits viral genome replication

94
Q

What is the major adverse effect associated with zanamivir?

A

it may cause bronchospasm in asthmatics

95
Q

What is responsible for the selectivity of acyclovir?

A

viral kinase and polymerase specificity

96
Q

What is the mechanism of action of acyclovir?

A

it is a guanosine analog and chain terminator which inhibits viral genome replication

97
Q

Most protease inhibitors are associated with which adverse effects?

A

lipodystrophy and metabolic syndrome

98
Q

How is zidovudine used clinically?

A

it’s short half life limits it to use with lamivudine to reduce mother-to-newborn transmission

99
Q

What are the side effects of ganciclovir?

A

due to reduced selectivity compared to acyclovir

  • teratogenic
  • myelosuppressive
  • neuropathic

Infectious Disease (9 decks)

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