Burkin: Viral Pharmacology Flashcards
List the DNA viruses
Herpes Simplex Virus Herpes Zoster CMV HHV 6/HHV 7 EBV Adenovirus Papilloma
Influenza is an RNA virus made up of influenza A, B, and C. Which type can be serotyped based on antibody responses to Hemagglutinin and neuraminidase on the outside of the viral particle?
Influenza A
How many different subtypes of the H antigen for influenza are there? How many are commonly found in humans? How many different subtypes of the N antigen are there? How many are commonly found in humans?
16H, only H1, H2, and H3 found in humans;
9N, only N1 and N2 commonly found in humans
What step in Infleunza viral replication does AMANTADINE block? What does it bind to on the influenza virus?
Amantadine binds to M2 protein of infleunza A2 and possibly inhibits the uncoating of the virus - this prevents the spread of influenza A2 and reduces duration of symptoms
What are the adverse reactions caused by amantadine?
dizzy nervous confused hallucinating low BP
What is amantadine useful for?
preventing the spread of influenza A2
What do Zanamivir and Oseltamivir do?
they are neuraminidase inhibitors - inhibit replication of influenza A and B
What are some adverse reactions caused by zanamivir and oseltamivir?
nauseous vomiting diarrhea abdominal pain headache
What type of antiviral is acylovir?
purine nucleotide analog
What is the mechanism of action of acyclovir, gancyclovir, pencyclovir, ribavirin?
AcycloGTP inhibits viral DNA polymerase, causing chain termination
What is acyclovir used for?
Herpes simplex (esp genital herpes) Varicella-Zoster
How is acyclovir activated?
by viral thymidine kinase
What are some adverse reactions caused by acyclovir?
IV admin can cause phlebitis (inflammation of leg/arm veins), irritation, nephrotoxicity;
oral admin can cause headache, vertigo, diarrhea, nausea, the whole deal
How is Gancylovir similar to acyclovir? How is it different? What is it used for?
structures are similar;
both inhibit DNA polymerase, but gancylovir is activated by HCMV phosphotransferase (instead of thymidine kinase for ancylovir);
both used for Herpes simplex and Zoster, but gancyclovir
also very effective for human cytomegalovirus (HCMV)!!!
What is one adverse reaction to be aware of when administering gancylovir?
bone marrow suppression
How does ribavirin monophosphate work?
How does ribavirin triphosphate work?
inhibits guanine nucleotide synthesis;
inhibits RNA polymerase
What is ribavirin used for?
BROAD SPECTRUM: myxovirus, paramyxovirus, adenovirus, herpes, etc.
Also, RSV and HepC
List 7 steps in the replication of HIV. Just think about it.
- HIV binds when gp120 binds to CD4 and CCR5. gp 41 brings em close.
- reverse transcriptase takes RNA back to DNA
- DNA integrated into host genome
- viral RNA replicated
- protease cleaves into proteins necessary for virus to thrive
- assembly of virions
- RELEASE THE VIRIONS
Zidovudine is also called AZT (azidothymidine). How does this work in cases of HIV?
triphosphate preferentially inhibits reverse transcriptase
What does AZT do for the host?
increases CD4 counts
decreases opportunistic infection
increases survival time
What is AZT used in combination with for the best results?
HAART - highly active anti-retroviral therapy
What are some adverse reactions to AZT?
bone marrow depression --> anemia granulocytopenia headache nausea vomiting myalgia myopathy
How do dideoxynucleosides (nRTIs) work for HIV? What are they esp useful for?
competitive inhibitors of reverse transcriptase, so they cause chain termination;
useful for AZT-resistant HIV
How does nevirapine work for HIV? **these are non-nucleoside reverse transcriptase inhibitors
binds to a different site than RTIs to inhibit reverse transcriptase, used in combination with reverse transcriptase inhibitors
What are some adverse reactions caused by non-nucleoside RTIs (nnRTIs)?
rashes
Stevens-Johnson syndrome
metabolized by CytoP450s
What are some of the protease inhibitors?
Amprenavir
Indinavir
Ritonavir
Saquinavir
How do the protease inhibitors work?
they block aspartate protease so they block the cleaving of proteins needed for HIV replication - block viral “maturation”
What are protease inhibitors used in combination with to treat HIV?
AZT and nucleotide analogs
What is an adverse reaction caused by protease inhibitors (-avirs)?
metabolic syndrome
What is an antiretroviral fusion inhibitor?
enfuviritide - it prevents the fusion of HIV virus with the host cell
