Dr. Hall Flashcards
CMV
Cytomegalovirus
Sites where antivirals work
- Viral attachment/ entry
- Uncoating
- Nucleic acid synthesis
- Transcription/ translation
- Packaging/Assembly
- Release
Single stranded RNA virus
-Influenza
Which type of influenza is responsible for pandemcis
-Influenza A
Drifts lead to
- Epidemics
- Minor changes/point mutations
Shifts lead to
- Pandemics
- Major changes resulting in antigen alterations
MoA of Neuraminidase inhibitors
- Interfere with viral release from host cells
- Active on both influenza A and B
Tamiflu
- Oseltamivir (oral)
- Neuraminidase inhibitor
Relenza Diskhaler
- Zanamivir (inhalable)
- Neuraminidase inhibitor
- Do NOT use in COPD/Asthma pts
Rapivab
- Peramivir (IV)
- Neuraminidase inhibitor
- Single dose
Potential side effect of all Neuraminidase inhibitors
- Potential to cause neuropsychiatric events
- Confusion, delirium, hallucinations
Xofluza
- Baloxavir
- New influenza drug with new MoA
- Cleaves primer from host RNA “Cap snatching”
- No viral mRNAs = no infection
Amatadine and Rimantadine
- Blockade of the influenza M2 proton ion channel
- Interferes with uncoating
- No longer used due to development of resistance
HSV 1
- Oral herpes (cold sores)
- Docosanol (Abreva)
- Peniciclovir (Denavir)
Abreva (OTC)
- Docosanol
- Aliphatic alcohol
- Blocks fusion between HSV envelope and host cell membrane
- Apply 5x daily
Denavir
- Peniciclovir
- Topical nucleoside analog
- Competes with dGTP analog for viral polymerase
HSV 2
-Genital herpes
VZV
- Chickenpox
- Can later emerge as herpes zoster (Shingles)
CMV
- Infects severely immunocompromised patients
- Organ transplant
- Often result of viral reactivation
Zovirax
- Acyclovir
- Nucleoside analog
- Used to treat HSV 2
- Poorly absorbed (multiple small doses helps)
- Resistance through viral TK alteration or DNA polymerase
Cytovene
- Ganciclovir (IV)
- Treatment of choice
- Nucleoside analog
- Impairment of fertility, fetal toxicity, mutagenesis/carcinogenesis
Valcyte
- Valganciclovir (oral)
- Prodrug of Ganiciclovir (Cytovene)
- Treatment of choice
- Nucleoside analog
Foscavir
- Foscarnet
- Used to treat REFRACTORY cases of CMV
- Do not require activation by viral TK
- Resistance = mutations in DNA polymerase
- Can remain in bone for several months
Cidofovir
- Used to treat REFRACTORY cases of CMV
- Do not require activation by viral TK
- Nephrotoxicity, neutropenia, carcinogenic/teratogenic
Prevymis
- Letermovir
- Prophylaxis for CMV
Prevymis
- Letermovir
- Prophylaxis for CMV
HAV epidemiology
- Single stranded RNA virus
- Self limiting
- Treat with supportive care
HBV epidemiology
- Double stranded DNA virus
- Reactivation is primary concern
- Can insert into human DNA and lay dormant for years
HCV epidemiology
- Single stranded RNA virus
- Chronic
- Not curable
Why should pts be tested for HIV before starting HBV therapy?
- Many of the treatment options in HBV are the same as in HIV
- However monotherapy is appropriate in HBV but NOT in HIV
- If pt is also HIV positive us multiple drug therapy
Viread
- Tenofovir disproxil fumarate
- Adenosine nucleotide analog
- To treat chronic HBV infection
Baraclude
- Entecavir
- Cyclopentyl guanosine nucleoside analog
- Inhibits HBV polymerase
- Take on empty stomach
Baraclude
-Entecavir
Name clue -previr
- NS3/4A
- Protease inhibitor
- Used to treat HCV
- NOT for patients with advanced liver disease
Name clue -asvir
- NS5A
- Replication complex inhibitor
- Used to treat HCV
Name clue -buvir
- NS5B
- Polymerase inhibitor
- Used to treat HCV
Mavyret
- Glecaprevir/Pibrentasvir)
- Covers all HCV genotypes
- Take with food
Epclusa
- Sofosbuvir/Velpatasvir
- Covers all HCV genotypes
- Sofosbuvir is a prodrug
Harvoni
- Ledipasvir/sofosbuvir
- Treats HCV genotypes 1,4
- Avoid administration with acid suppressive therapy
Ribatol or Ribashpere
- Ribavirin
- Can be added on to Epclusa or Harvoni for the sickest of patients
- Only used in combo with the drugs stated above
- DO NOT use as monotherapy
- Take with high fat meal
Ribatol or Ribashpere
- Ribavirin
- Can be added on to Epclusa or Harvoni for the sickest of patients