Chapter 40: Antivirals pg650 Flashcards

1
Q

Viruses can enter the body through at least four routes:

A

inhalation
through the respiratory tract, ingestion via the gastrointestinal
(GI) tract, transplacentally via mother to infant, and
inoculation via skin or mucous membranes.

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2
Q

changes in the cell associated

with viral replication are known as the

A

cytopathic effect and

usually result in the destruction of the host cell.

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3
Q

Drugs that actually destroy virions include

A

disinfectants and immunoglobulins. Disinfectants such
as povidone-iodine (Betadine) are virucides and are commonly
used to disinfect medical equipment

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4
Q

Many drugs for the treatment of HIV are approved by the

U.S. Food and Drug Administration (FDA) via an

A

accelerated
process, which means that they are approved faster than other
drugs, because of the nature of the illness.

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5
Q

All virions contain a genome that consists

of either DNA or RNA

A

antiviral
drugs interfere with viral nucleic acid synthesis. Other antiviral
drugs work by preventing the fusion process

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6
Q

opportunistic

infections

A

infections caused by organisms

that would not normally harm an immunocompetent person

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7
Q

Most antiviral drugs

are

A

synthetic purine or pyrimidine nucleoside or nucleotide

analogues

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8
Q

Antiretroviral drugs

A

are indicated specifically for
the treatment of infections caused by HIV, the virus that causes
AIDS.

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9
Q

Herpes simplex virus type 1 HSV 1

A

causes mucocutaneous herpes—usually in the form of perioral

blisters (“fever blisters” or “cold sores”).

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10
Q

Herpes simplex

virus type 2 (HSV-2)

A

causes genital herpes

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11
Q

Human herpesvirus

3 (HHV-3)

A

causes both chickenpox and shingles. This virus is
more commonly known as herpes zoster virus or varicella-zoster
virus (VZV)

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12
Q

Human herpesvirus 4 (HHV-4),

A

known as Epstein-Barr virus, is associated with illnesses such
as infectious mononucleosis (“mono”) and chronic fatigue
syndrome.

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13
Q

Human herpesvirus 5 (HHV-5)

A

known as cytomegalovirus (CMV) and is the cause of CMV retinitis
(a serious viral infection of the eye) and CMV disease, which
is most commonly seen in immunocompromised patients

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14
Q

Human herpesvirus

8

A

known as Kaposi’s sarcoma herpesvirus, is an oncogenic
(cancer-inducing) virus believed to cause Kaposi’s sarcoma, an
AIDS-associated cancer

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15
Q

Chickenpox, highly contagious

A

spread by either direct contact with weeping lesions or via

droplet inhalation

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16
Q

Zoster lesions are

often quite painful

A

opioids for
pain control. In addition, postherpetic neuralgias (long-term
nerve pain) remain following shingles outbreaks in up to 50%
of elderly patients

17
Q

vaccines…

A

varicella virus vaccine was approved in 1995, older than 1 yr old, never had chicken pox
Zostavax, is available for prevention of herpes shingles in
patients 50 years of age or older

18
Q

Because viruses reproduce in human cells

A

selective killing is
difficult
healthy human cells, in addition
to virally infected cells, may be killed in the process, which
results in more serious toxicities for these drugs

19
Q

Amantadine (Symmetrel) narrow antiviral spectrum…

A

influenza A viruses

rimantadine

20
Q

Valacyclovir is a

A

prodrug that is metabolized to acyclovir
in the body

greater oral bioavailability

21
Q

A common

site of CMV infections in the immunocompromised patient

A

the eye, and it can result in CMV retinitis, a devastating viral
infection that can lead to blindness

Ganciclovir

22
Q

The dose-limiting toxicity of ganciclovir treatment

A

is bone
marrow suppression, whereas that of foscarnet and cidofovir
is renal toxicity.

23
Q

For example, a heart transplant recipient who contracts CMV
retinitis is immunocompromised because of immunosuppressant
drug therapy and is most likely taking cyclosporine

A

which
is nephrotoxic. Therefore, using foscarnet in this patient may
be more dangerous than using ganciclovir

24
Q

a patient who contracts a CMV infection and is immunocompromised
because of a bone marrow transplant might be better
treated using

A

fosarnet

25
Q

Ribavirin (Virazole) is a synthetic nucleoside analogue of guanosine

A

It interferes with both RNA
and DNA synthesis and as a result inhibits both protein synthesis
and viral replication overall.

26
Q

stages of HIV
The most recent WHO model
lists four stages as follows:

A
  • Stage 1: asymptomatic infection
  • Stage 2: early, general symptoms of disease
  • Stage 3: moderate symptoms
  • Stage 4: severe symptoms, often leading to death
27
Q

CD4 refers to the

A

protein on the cell surface of helper

T lymphocytes, to which HIV virions attach themselves

28
Q

(HAART) refers to

A
Highly active antiretroviral
therapy
combinations of antiretroviral
drugs (“cocktails”) that are now standard for treating
HIV-infected patients.
29
Q

Zidovudine (Retrovir), also known as azidothymidine or AZT

A

is given to HIV-infected pregnant
women and even to newborn babies to prevent maternal transmission
of the virus to the infant

30
Q

Ribavirin

is contraindicated

A

in pregnant women and in their male
sexual partners due to its teratogenic properties; it must also
not be handled by health care personnel who are or might
be pregnant

31
Q

Ganciclovir is associated

A

with bone marrow
suppression; therefore, assess blood counts prior to and
during use.

32
Q

With use of HIV antivirals or antiretrovirals,

A

Bone demineralization is yet another adverse effect
with long-term use, so assessment of calcium and vitamin
D levels is crucial

33
Q

Instruct the patient to take oral antivirals

A

with meals to help
minimize GI upset. Also advise the patient to store capsules at
room temperature and not to crush or break the capsules

34
Q

Amantadine and other antivirals need to be taken for the

A

entire course of therapy, and, if a dose is missed, instruct the
patient to take the dose as soon as it is remembered or contact
the prescriber for further instructions

35
Q

How is the effectiveness of antiviral drugs administered to treat HIV infection assessed and evaluated?

A

All antiretroviral drugs work to reduce the viral load, which is the number of viral RNA copies per milliliter of blood.

36
Q

Viruses can enter the body through at least four routes:

A

inhalation through the respiratory tract, ingestion via the GI tract, transplacentally via mother to infant, and inoculation via skin or mucous membranes. The inoculation route can take several forms, including sexual contact, blood transfusions, sharing of syringes or needles, organ transplantation, and animal bites (including human, animal, insect, spider, and others).