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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
What is the mechanism of action of dolutegravir?
it is an HIV integrase inhibitor
26
What is special about the pharmacokinetics of oseltamivir?
it is given as a prodrug that must be activated in the gut and liver
27
How and when is rimantadine given?
orally within the first 48 hours of exposure
28
What benefit does lamivudine offer to those with HBV?
- management of their infection | - reduced risk of HCC
29
List five drugs used to treat herpes by inhibiting viral genome replication.
- acyclovir - ganciclovir - foscarnet - cidofovir - trifluridine
30
What is emtricitabine?
a fluorinated form of lamivudine
31
List the three important anti-influenza medications.
- rimantidine - oseltamivir - zanamivir
32
Describe the selectivity of trifluridine.
it has very low specificity, activated by hosts kinases and low polymerase specificity
33
What is the primary adverse effect of foscarnet and how do we deal with it?
it is potentially nephrotoxic, so use a saline preload
34
Oseltamivir is also known as what?
tamiflu
35
What is the advantage of using atazanavir compared to other HIV PIs?
it has no associated lipodystrophy or metabolic syndrome
36
What is the mechanism of action of enfuvirtide?
it binds gp41 and serves as a fusion inhibitor
37
What is rimantadine used to treat?
influenza A
38
What is alafenamide?
a form of tenofovir with less renal toxicity and bone loss
39
What is the mechanism of action for nevirapine?
it is a non-competitive inhibitor of HIV RT
40
What are the benefits of dolutegravir over other HIV integrase inhibitors?
resistance develops more slowly and there is less hepatotoxicity
41
What is the mechanism of action of zanamivir?
it blocks neuraminidase
42
What is ganciclovir used to treat?
retinitis and visceral effects of CMV
43
What is the mechanism of action of darunavir?
it is an HIV protease inhibitor
44
What are the adverse effects of interferon alpha?
- may induce autoantibodies | - flu-like syndrome
45
Darunavir is often given alongside what other drug?
cobistat
46
Name two CYP3A4 inhibitors used to enhance the bioavailability of HIV protease inhibitors.
- cobicistat | - ritonavir
47
How is telaprevir metabolized?
via CYP3A4 and Pgp
48
Anti-HIV agents fall into what six categories?
- binding inhibitors - fusion inhibitors - integrase inhibitors - nucleoside RT inhibitors - non-nucleoside RT inhibitors - protease inhibitors
49
What is interferon-alpha used to treat?
- HBV management | - HCV eradication (with ribavirin)
50
What polymorphisms affects the effect of simeprevir?
Asians have 3x higher bioavailability
51
How is cidofovir cleared from the body?
active tubular secretion
52
How does the selectivity of ganciclovir compare to that of acyclovir?
it is less kinase and polymerase specific than acyclovir
53
Describe the selectivity of cidofovir?
it has no kinase specificity, just polymerase specificity
54
Cidofovir has what adverse effect?
dose-dependent nephrotoxicity
55
What is the mechanism of action for tenofovir?
it is a chain terminating NRTI
56
How well tolerated is acyclovir?
very well given its high selectivity
57
Which five nucleoside RT inhibitors are effective against HIV?
- zidovudine - lamivudine - emtricitabine - abacavir - tenofovir
58
What drug combination is used for HCV eradication?
12-24 week course of - interferon alpha - ribavirin - sofosbuvir
59
What is the mechanism of action of trifluridine.
it competes with TTP for viral polymerase
60
What is the mechanism of action of lamivudine?
it is a cytosine analog that inhibits HIV RT and HBV DNA polymerase
61
What is the mechanism of action of raltegravir?
it is an HIV integrase inhibitor
62
Cidofovir is usually given alongside what other drug?
probenecid to increase bioavailability
63
What is the mechanism of action of zidovudine?
- a thymidine analog and chain terminator | - nucleoside RT inhibitor
64
What are the disadvantages of raltegravir?
- resistance develops quickly | - can't take with cations or other buffered drugs
65
What is the mechanism of action of efavirenz?
it is a NNRTI for HIV
66
What is the mechanism of action of indinavir?
it is an HIV protease inhibitor
67
What are the adverse effects of ribavirin?
- known teratogen and embryotoxin | - may cause a dose-dependent anemia
68
How is efavirenz taken to increase bioavailability?
take it on an empty stomach
69
What is the mechanism of atazanavir?
it is an HIV protease inhibitor
70
Tenofovir is part of what HIV regimen?
PReP
71
What are the disadvantages of nevirapine?
- inducer of CYP3A4 - resistance emerges quickly - causes a skin rash
72
Which viruses are resistant to acyclovir?
those that are without thymidine kinase
73
What is the mechanism of efavirenz?
it is an HIV NNRTI
74
What is zanamivir used to treat?
influenza A and B
75
When is cobicistat contraindicated?
when patients have a GFR less than 30
76
How is the bioavailability of interferon-alpha improved?
using a pegylated formulation
77
What are the adverse effects of indinavir?
it causes hyperbilirubinemia and nephrolithiasis
78
What is the mechanism of action of foscarnet?
it is a pyrophosphate anti-metabolite which directly inhibits viral polymerase to prevent viral genome replication
79
What are the indications for ribavirin?
- orally and with INFa for HepC | - as an aerosol for respiratory syncytial virus
80
What are the two adverse effects of simeprevir?
- photosensitivity rash | - sulfa moiety that causes Steven-Johnson syndrome
81
What is the most significant adverse effect of abacavir?
a severe hypersensitivity reaction predicted by HLA-B5701
82
What is foscarnet used to treat?
- synergistic with ganciclovir for CMV | - used for valcyclovir-resistant herpes simplex
83
How does resistance to zidovudine develop?
through RT mutations
84
What is the mechanism of action of telaprevir?
it is an HCV protease inhibitor
85
What is responsible for the selectivity of ribavirin?
- it has no kinase selectivity | - it has a selectivity for viral polymerase
86
What is the mechanism of action of oseltamivir?
it blocks neuraminidase
87
What is cidofovir used to treat?
herpes simplex and CMV
88
What are the adverse effects of maraviroc?
- hepatotoxicity preceded by an allergic reaction | - cough, myalgia, diarrhea
89
What is the mechanism of action of sofosbuvir?
it inhibits HCV RNA polymerase
90
Lamivudine is used in the treatment of which two conditions?
HBV and HIV management
91
What are the two forms of tenofovir?
- alafenamide | - disoproxil
92
What is cobicistat?
a CYP3A4 inhibitor used to extend the bioavailability of HIV protease inhibitors
93
What is the mechanism of action of ganciclovir?
it is a guanosine analog anti-metabolite which inhibits viral genome replication
94
What is the major adverse effect associated with zanamivir?
it may cause bronchospasm in asthmatics
95
What is responsible for the selectivity of acyclovir?
viral kinase and polymerase specificity
96
What is the mechanism of action of acyclovir?
it is a guanosine analog and chain terminator which inhibits viral genome replication
97
Most protease inhibitors are associated with which adverse effects?
lipodystrophy and metabolic syndrome
98
How is zidovudine used clinically?
it's short half life limits it to use with lamivudine to reduce mother-to-newborn transmission
99
What are the side effects of ganciclovir?
due to reduced selectivity compared to acyclovir - teratogenic - myelosuppressive - neuropathic

Infectious Disease (9 decks)

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