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Pharm > Exam 2: Antivirals > Flashcards

Exam 2: Antivirals Flashcards

1
Q

Therapeutic use: Tx of herpes and varicella zoster.
MOA: viral thymidine kinase phosphorylates–>acyclovir triphosphate=>premature chain termination
AE/Toxicity: NV, HA, diarrhea, renal dysfunction–>keep pts hydrated!!
Resistance: altered or deficient thymidine kinase r polymerase
Notes: t1/2 is 2.5h

Tx of HSV, VZV, and Megalovirus

A

Acyclovir

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2
Q

Therapeutic Use: CMV retinitis and prevention of CMV in transplant pt.
MOA: Inhibits DNA polymerase–>block chain elongation
AE/Toxicity: dose-dependent neutropenia, CNS effects, carcinogenic.
Resistance:
Notes: t1/2 is 24 hrs, more potent than acyclovir. “Gang” up on CMV!

Tx of HSV, VZV, and Megalovirus

A

Ganciclovir

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3
Q

Therapeutic Use: IV Tx for CMV retinitis in HIV pt who are resistant to ganciclovir and herpes pts who are resistant to acyclovir
MOA: Blocks DNA replication and RNA transcription.
AE Toxicity: nephrotoxicity, anemia, nausea, fever, hypocalemia, hypomagnesia.
Resistance:
Notes: Second-line therapy

Tx of HSV, VZV, and Megalovirus

A

Foscarnet

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4
Q 
Therapeutic Use: HSV keratoconjunctivitis and keratitis.
	MOA: Blocks viral DNA replication
	AE Toxicity: inflammation to cornea.
	Resistance:
	Notes: Replaced Idoxuridine

Tx of HSV, VZV, and Megalovirus

A

Trifluridine

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5
Q

Therapeutic Use: shorten duration and prevent flu
MOA: inhibit neuraminidase=decr release of virus from infected cells, incr formation of viral aggregates, and decr viral spread
AE Toxicity: nasal/throat discomfort; bronchospasm
Resistance:
Notes: OZ has the flu!

Neuraminidase Inhibitors
tx viral respiratory inf

A

Zanamivir

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6
Q

Therapeutic Use: shorten duration and prevent flu.
MOA: inhibit neuraminidase=decr release of virus from infected cells, incr formation of viral aggregates, and decr viral spread
AE/Toxicity: NV, HA
Resistance:
Notes: Good for both influenza A and B; take with food=less nausea

Neuraminidase Inhibitors
tx viral resp inf

A

Oseltamivir (Tamiflu)

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7
Q

Therapeutic Use: genital warts, chronic hep B & C, Kaposi’s sarcoma (HHV-8), multiple melanomas, multiple sclerosis.
MOA: activate JAK-STAT pathway; induce 2 enzymes=inhibit protein synthesis.
AE/Toxicity: flu-like, bone marrow suppression, fatigue, increased susceptibility to bacterial infections, psychiatric symptoms.
Resistance:
Notes: Peg-IFN 2A WITH Ribavirin is Tx of choice for chronic hep C.

tx of hep viral inf

A

Interferons

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8
Q

Therapeutic Use: chronic hep C, RSV, flu A & B, parainfluenza A & B, paramyxovirus, arenavirus, HIV==>RIBAvirin – RSV, Influenza B, Arenavirus
MOA: inhibits viral mRNA synthesis
AE Toxicity: anemia, teratogenic=don’t give if pregnant
Resistance:
Notes: Standard choice for hep C; give with IFN

tx of hep viral inf

A

Ribavirin

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9
Q

Therapeutic Use: most freq given to HIV pt; protect fetus from HIV infected mother.
MOA: NRTI
AE Toxicity: bone marrow suppression, HA, potentially fatal lactic acidosis.
Resistance: mutated rev. transcriptase will have a lower affinity for AZT-TP
Notes: Probenecid, Acetaminophen, Lorazepam, Indomethacin, Cimetidine increase toxicity=>“I am a PAL I Care”
Trizivir: Zidovudine (AZT), Lamivudine (3-TC), and Abacavir

A

Zidovudine (AZT)

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10
Q

Therapeutic Use: pt with AZT-resistant HIV infection.
MOA: NRTI
AE Toxicity: Pancreatitis, potentially fatal non-cirrhotic portal hypertension.
Resistance: mutated reverse transcriptase
Notes: DO NOT use as first-line therapy; toxicity increased with stavudine.

A

Didanosine (ddI)

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11
Q 
Therapeutic Use: give with AZT or alone if pt can't tolerate AZT.
	MOA: NRTI
	AE Toxicity: Peripheral neuropathy
	Resistance:
	Notes:  The ZZ is given together.
A

Zalcitabine (ddC)

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12
Q

peripheral neuropathy toxicity with potentially fatal lactic acidosis with AZT.

A

Stavudine

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13
Q

Zidovudine, Abacavir, Lamivudine–>TriZAL

A

Trizivir

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14
Q

Therapeutic Use: Pt with HIV in combo with AZT and/or hep B.
MOA: NRTI
AE Toxicity: Pancreatitis in peds.
Resistance:
Notes: part of Trizivir. Reduces chance pt becomes resistant to AZT.

A

Lamivudine (3-TC)

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15
Q

Therapeutic Use: HIV adults and peds in combo with AZT and lamivudine or protease inhibitor.
MOA: NRTI
AE Toxicity: Hypersensitivity resulting in fever, GI distress, malaise and rash.
Resistance:
Notes: part of Trizivir

A

Abacavir

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16
Q

Therapeutic Use: HIV pt and chronic hep B. Can prevent HIV prophylactically.
MOA: NtRTI (nucleotide reverse transcriptase inhibitor) and terminates DNA elongation.
AE Toxicity:
Resistance:
Notes: Do not give as didanosine, lamivudin, or abacavir combo. Gel for vagina

A

Tenofovir

17
Q

Therapeutic Use: used in combo with AZT and lamivudine for HIV.
MOA: NNRTI; alters conformation of reverse transcriptase.
AE Toxicity: dizziness, HA, insomnia, rash
Resistance:
Notes: Co-admin with Rifampin will reduce levels. Efavirenz can lower [] of many drugs.

Non-Nucleoside Reverse Transcriptase Inhibitos (NNRTIs)

A

Efavirenz

18
Q

Therapeutic Use: use in combo with Didanosine or Stavudine
MOA: Alters conformation of reverse transcriptase.
AE Toxicity: Rash
Resistance: Don’t ever take St. John’s Wart, its Stupid! Lowers ethinyl estradiol (estrogen) levels with birth control pills.
Notes: Nevir take St. John’s Wart and change birth control with Nevirapine, cause John likes to go bareback!

Non-Nucleoside Reverse Transcriptase Inhibitos (NNRTIs)
A

Nevirapine

19
Q

Therapeutic Use: used in combo with Zidovudine and Didanosine
MOA: NNRTI; binds and inhibits rev. transcriptase of HIV.
AE Toxicity: many effects on various CYPs
Resistance:
Notes: least potent NNRTI

A

Delaviridine

20
Q

Therapeutic Use: treat HIV that are resistant to multiple protease inhibitors.
MOA: Protease inhibitors.
AE Toxicity: Diarrhea, N /F/ HA, hyperlipidemia, hyperglycemia, altered body fat.
Resistance: Has CYP effects.
Notes: Ritonavir inhibits CYP 3A4 so it raises levels of Lopinavir.

A

Lopinavir / Ritonavir

21
Q

Therapeutic Use: injected daily in HIV pt.
MOA: Fusion inhibitor
AE Toxicity: pain, redness, nodule, cysts at injection.
Resistance:
Notes:

A

Enfuvirtide

22
Q 
Therapeutic Use:  HIV pt
	MOA: Fusion inhibitor
	AE Toxicity: cough, fever, dizziness, HA, lowered BP, nausea, and bladder irritation.
	Resistance:
	Notes:
A

Maraviroc

Pharm (19 decks)

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