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Pharmacology II > Ch 43 > Flashcards

Ch 43 Flashcards

1
Q

herpes viruses

A
  • herpes simplex
  • varicella zoster
  • cytomegalovirus
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2
Q

nucleoside analogue (acyclovir family) MOA

A

compete with endogenous nucleosides, competitively inhibits viral DNA polymerase, prevent synthesis of viral DNA

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3
Q

acyclovir

A
  • IV is DOC for serious HSV infections

- oral is more effective than topical for genital herpes

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4
Q

nucleoside analogues ADE

A
  • GI disturbances
  • headache
  • rash
  • IV acyclovir can cause phlebitis and reversible renal dysfunction
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5
Q

penciclovir

A

-topical for herpes labialis (cold sore)

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6
Q

ganciclovir

A
  • DOC for cytomegalovirus

- ophthalmic gel for HSV keratitis

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7
Q

ganciclovir ADE

A
  • leukopenia
  • thrombocytopenia
  • myelosuppression
  • retinal detachment
  • liver/renal dysfunction
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8
Q

cidofovir

A
  • reserved for infections resistant to ganciclovir and other drugs due to more serious ADE
  • nephrotoxicity, neutropenia, metabolic acidosis
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9
Q

trifluridine

A

ophthalmic topical for ocular HSV infection

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10
Q

foscarnet

A
  • IV only
  • used for CMV retinitis in AIDS
  • acyclovir resistant HSV and shingles
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11
Q

foscarnet ADE

A
  • renal impairment and acute renal failure
  • hematologic toxicity
  • cardiac arrhythmia
  • heart failure
  • seizure
  • pancreatitis
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12
Q

HAART

A
  • highly active antiretroviral therapy

- concept of multidrug use that has markedly reduced viral loads and improved survival

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13
Q

HIV

A

-RNA retrovirus that enters the cell and acts as a template to produce viral DNA via reverse transcriptase

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14
Q

nucleoside reverse transcriptase inhibitors (NRTIs)

A
  • 1st class of drugs for HIV+ and included in almost all HIV regimen
  • use of multiple is synergy, not duplication, due to each drug focusing on different DNA base
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15
Q

nonnucleoside reverse transcriptase inhibitors (NNRTIs)

A
  • efavirenz is most potent and preferred

- viral resistance happens quickly and must be combined with other drugs

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16
Q

nonnucleoside reverse transcriptase inhibitors (NNRTIs) MOA

A

bind directly to reverse transcriptase and disrupt the catalytic site

17
Q

nonnucleoside reverse transcriptase inhibitors (NNRTIs) ADE

A
  • rash
  • possible Stevens Johnson
  • teratogenic
  • neuropsychiatric reaction
18
Q

protease inhibitor MOA

A

bind to the protease enzyme and inhibit proteolytic activity, resulting in immature and noninfectious viral particles

19
Q

ritonavir

A

inhibits metabolism of other protease inhibitors which raises plasma levels and duration of action

20
Q

fusion and entry inhibitors

A
  • inhibit the fusion and entry of HIV

- active for HIV resistant to reverse transcriptase inhibitors and protease inhibitors

21
Q

integrase strand transferase inhibitor MOA

A
  • incorporates viral DNA formed by reverse transcriptase into the DNA of CD4 cells
  • effective against resistant strands
22
Q

integrase strand transferase inhibitor ADE

A
  • headache

- N/V/D

23
Q

preferred initial HIV treatment regimen

A

2 NRTI + NNRTI or PI

  • change therapy due to treatment failure (decrease CD4 or increase viral load) or drug toxicity
  • failure to respond to regimen needs at least 2 new drugs for alternate regiment
24
Q

neuraminidase inhibitors MOA

A
  • inhibits neuraminidase that catalyzes reaction that causes viral spread in influenza A and B
  • most effective less than 3 days after onset with less than 2 days preferred
25
Q

neuraminidase inhibitor indications

A
  • hospitalized for influenza
  • severe, complicated, progressive illness
  • higher risk of complication
26
Q

neuraminidase inhibitor prophylaxis

A
  • routine prophylaxis not advised due to viral resistance

- requires therapy throughout period of potential exposure and 7 days afterward

27
Q

amantanes

A

-no longer used clinically for flu due to resistant strains

28
Q

endonuclease inhibitor (baloxavir)

A

-single dose within 48 hours of onset of flu symptoms

29
Q

tenovir

A

DOC for chronic hepatitis B

30
Q

ribavarin

A
  • aerosol treatment for RSV

- oral treatment for hepatitis C

31
Q

ribavarin ADE

A
  • apnea, pneumothorax, cardiac arrest
  • hemolytic anemia
  • teratogenic

Pharmacology II (19 decks)

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