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Infectious Disease > Drugs Four Last Time > Flashcards

Drugs Four Last Time Flashcards

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1
Q

Herpesvirus group and ones there is treatment for

A
  • Herpes simplex
  • Varicella zoster
  • cytomegalovirus
  • epstein barr (no treatment)
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2
Q

Acyclovir

A

Agent of choice for herpes symplex and varicella zoster virus functions to inhibit viral DNA poly and incorporate into strand of viral DNA blocking further growth through cell conversion into acyclo-GMP

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3
Q

Acyclovir absorption

A

Topical, oral, IV

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4
Q

Acyclovir ADR’s

A

None!

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5
Q

Acyclovir resistance (3)

A
  • decreased production of thymidine kinase
  • alteration of thymidine kinase
  • alteration of viral DNA poly so its less sensitive to inhibition
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6
Q

Acyclinovir is not a…

A

…cure for the virus, it just decreases symptoms

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7
Q

Vlacyclovir

A

More popular prodrug form of acyclovir, approved for PO therapy in immunocompetent host

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8
Q

Vlacyclovir ADR

A

Immunocompromised patients experience thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS)

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9
Q

Famciclovir

A

-Same as acyclovir but used only for acute herpes zoster and herpes simplex genitalis

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10
Q

Penciclovir

A

Topical drug indicated for recurrent herpes labialis (cold sores) in immunocompetent adults caused by HSV1 and 2

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11
Q

Docosanol

A

OTC treatment for herpes labialis, inhibits fusion btwn plasma membrane and viral envelope increasing healing with first sign of coldsore

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12
Q

Ganciclovir

A

Synthetic antiviral agent with activity against cytomegaolvirus

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13
Q

CMV in immunocompromised patient (AIDS) leads to…

A

CMV retinitis and eventual blindness

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14
Q

Valganciclovir

A

Prodrug version of ganciclovir with PO formulation but same indications for CMV retinitis and prevention and results

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15
Q

Ganciclovir ADRs

A

serious ADRS such as granulocytopenia and thrombocytopenia and hsould be restricted to treat CMV in immunocompromised host

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16
Q

Cidofir

A

Alternate for ganciclovir requiring fewer IV infusions

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17
Q

Cidofir ADRs

A
  • Nephrotoxicity
  • Probenecid and IV hydration therapy with each dose
  • granulocytopenia
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18
Q

Foscarnet

A

Alternative for ganciclovir for CMV retinitis, IV antiviral but does not cause granulocytopenia or thrombocytopenia

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19
Q

6 diff hepatitis viruses and do they become chronic

A 
A
B chronic (most common)
C chronic (most common)
D chronic
E
G
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20
Q

Hep C genotypes and their resistance

A

Genotype 1 - resistant, 75%

2-6 - susceptible, 25%

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21
Q

Direct acting antivriral drugs (DAAs)

A

Target specific steps in HCV replication without damage to healthy cells, often used in combination to decrease viral resistance

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22
Q

Categories of DAAs

A

1) NS3/4A protease inhibitors
2) NS5A inhibitors
3) NS5B nucleoside polymerase inhibitors (NPIs)
4) NS5B non nucleoside polymerase inhibitors (NNPIs)

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23
Q

Triple therapy regimen

A

Original standard of care for HepC until DAA development, includes pegylated interferon alfa (notorious for causing damage to host cell), protease inhibitor, and ribavirin

24
Q

Interferon alfa

A

prevents viral entry into cells, synthesis of viral RNA and proteins, and viral release

25
Q

Interferon alfa ADRs

A
  • Flu like symptoms
  • Mental health
  • alopecia
26
Q

Ribavirin

A

Combining with interferon alfa significantly improves responsiveness

27
Q

Ribavirin ADRs

A

Hemolytic anemia and birth defects

28
Q

2nd wave protease inhibitors used in triple therapy regimen

A
  • grazoprevir
  • paritaprevir
  • simeprevir
  • glecapavir
  • voxilaprevir
29
Q

Protease inhibitor mech of action (simeprevir)

A

Inhibits protease specific to HCV genotype 1 or 4 stopping replication, used in combo with other anti HCV drugs

30
Q

NS5A inhibtors

A

Target nonstructural proteins necessary for HCV RNA replication, resistance can develop easily so agents should never be given alone

31
Q

Example of an NS5A inhibitor

A

Daclatasvir

32
Q

NS5B inhibitors

A

Target proteins necessary for HCV RNA replication,

33
Q

NS5B NPI vs NNPI

A

NPI low likelihood of viral resistance, NNPI high likelihood

34
Q

Ganciclovir Mech of action

A

Conversion to active form within host cell gangciclovir triphosphate, competes for binding to viral DNA poly and incorporates into DNA chain causing termination

35
Q

Interferon alfa absoroption

A

-paraenterally usually subqutaneous

36
Q

Daclatasvir

A

PO acting antiviral drug approved for use for treatment of crhonic hep C or HCV virus

37
Q

Daclatasvir ADRs

A

Severe bradycardia when administered with other drugs

38
Q

Sofosbuvir

A

NS5B NPI metabolized by liver into active form acts on RNA poly, well tolerated

39
Q

Ledipasvir and sofosbuvir (harvoni)

A

Two PO antiviral agents used as a popular combination to treat HCV today

40
Q

Viekira pak

A

Fixed dose of two direct acting antiviral agents obmitasvir and paritaprevir (similar efficacy to harvoni but higher pill burdern and greater potential for drug reactions)

41
Q

Elbasvir/grazoprevir (zepatier)

A

Combo of NS5A inhibitor and NS3/4A protease inhibitor

42
Q

Technivie

A

Direct acting antiviral drugs combine ombinasvir and paritaprevir for treatment of chronic hep C

43
Q

Sofosbuvir/velpatasvir/voxilaprevir (Vosevi)

A

Fixed combo of nucleotide poly inhibitor, NS5A inhibitor nd NS3/4A protease inhibitor

44
Q

Unlike Hep C, for Hep B we have a…

A

..vaccine

45
Q

7 drugs used for chronic hep B

A

1) alfa interferon
2) peginterferon alfa
3) lamivudine
4) adefovir
5) entecavir
6) telbivudine
7) tenofovir

46
Q

Influenza exists as these 2 types and what causes most infections, as well as what are the 2 types of surface antigens

A

A - 95% of infections
B - 5%

Hemmagglutinin and neurominidase (H#N#)

47
Q

3 types of influenza vaccine

A

1) Inactivated
2)recombinant hemaglutinin vaccine
3) live attenuated vaccine
No more flu mist :(

48
Q

Guillain barre syndrome and its relationship to the flu vaccine

A

Severe paralytic illness, 1976 flu vaccine associated with GBS, but no link ever since

49
Q

Precautions to flu vaccine

A
  • acute febrile illness should absolve before vaccination

- chicken egg protein residual

50
Q

Who should receive the flu vaccine?

A

All people age 6 months or older unless severe allergic anaphylactic rxn

51
Q

Fluzone

A

High dose with 4x amount of antigen recomended for older adults

52
Q

Amantadine and Rimantidine

A

Antiviral drugs for prophylaxis and treatment of infections caused by type A influenza, mostly resistance strains now so not recommended

53
Q

Neuraminidase Inhibitors

A

Modestly suppress influenza A AND B, prophylacitc and treatment

54
Q

Olsetamivir

A

PO drug for treatment of uncomplicated influenza for those who have symptoms for no more than 2 days

55
Q

Olsetamivir mech of action

A

Inhibits neuraminidase viral enzyme required to for replication

56
Q

Zanamivir ADRs

A

Bronchospasm is greatest concern

57
Q

Zanamivir absorption

A

Oral inhalation

Infectious Disease (24 decks)

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