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Host and Defense > EXAM 3 Antivirals > Flashcards

EXAM 3 Antivirals Flashcards

1
Q

___ are the proteins that are on the surfaces of viruses that are recognized by the host’s immune system

A

antigens

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2
Q

during reproduction, antigens on newly formed viruses may evolve signle or few mutations that reduce the host’s immune system’s ability to recognize the virus. this describes ___

A

antigenic drift

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3
Q

___ describes changes that are significant or frequent enough to cause viral resistance, which may lead to epidemics

A

antigenic shifts

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4
Q

viral genetic material may be either ___ or ___, but generally contains only enough material for virus to replicate itself using the host

A

DNA-encoded or RNA-encoded

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5
Q

what is an example of a DNA-encoded virus?

A

herpes virus

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6
Q

what 6 drugs are inhibitors of viral transcription via inhibition of DNA polymerase?

A
  • acyclovir
  • valacyclovir
  • famcyclovir
  • penicyclovir
  • ganciclovir
  • foscarnet
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7
Q

what is an example of an RNA-encoded virus?

A

influenza virus

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8
Q

___ is an inhibitor of virual uncoating (M2 protein)

A

amantadine

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9
Q

___ is an inhibitor of viral translation by inhibition of RNA polymerase

A

ribavarin

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10
Q

___ and ___ are neuroaminidase inhibitors (prevent viral release)

A

zanamivir and oseltamivir

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11
Q

what are the two types of herpes simplex virus?

A
  • type 1 - HSV-1 or oral herpes
  • type 2 - HSV-2 or genital herpes
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12
Q

___ typically resides in ___ and causes sores around the mouth, throat, inside of the cheeks, front of the tongue, gums, roof of mouth, and lips (also known as fever blisters or cold sores)

A
  • HSV-1
  • trigeminal ganglia
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13
Q

___ typically resides in ___ and tends to re-occur in the genital area, inner thighs, and buttocks

A
  • HSV-2
  • sacral ganglia (at the base of the spine)
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14
Q

___% of americans will develop shingles at some point in their life

A

32%

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15
Q

1 in 6 americans aged 14-49 years are infected with ___

A

HSV-2

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16
Q

VZV is a member of the ___ family and causes ___ and ___

A
  • herpes (HHV3)
  • chickenpox (primary infection)
  • shingles (reactivation/recurrent)
  • *VZV = varicella zoster virus
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17
Q

T or F:

VZV (HHV-3) transmission can be given to individuals who have already been infected

A

false

VZV transmission is only to those individuals with no history of VZV infection or vaccine exposure

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18
Q

describe chickenpox

A
  • clinical presentation of VZV primary infection
  • contagiousness - lasts from 1-2 days pre-rash until all lesions are gone (7-10 days total)
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19
Q

describe shingles

A
  • clinical presentation of reactivated/recurrent VZV infection
  • may occur years-decaes after initial chickenpox, but most frequent later in life or during immunocompromise
  • postherpetic neuralgia
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20
Q

all members of the herpes virus family may establish ___ infections that become dormant, or ___, infections that may reactivate in response to various triggers

A
  • primary
  • latent
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21
Q

what are common triggers for reactivation of latent herpes viruses?

A

stress, fatigue, sun exposure, surgery, fever, menstrual periods, or being immunocompromised

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22
Q

the age-related decline in immune function, known as ___, increases the incidence of herpes reactivation (shingles) in elderly patients

A

immunosenescence

23
Q

what is the location, appearance, and contagiousness of canker sores?

A
  • location: inside the mouth and on the gums
  • appearance: white, yellow, or gray center and bright red border; can be single or in groups
  • contagious? no
24
Q

describe the cause, location, appearance, and contagiousness of cold sores

A
  • cause: HSV
  • location: mostly outside of the mouth
  • appearance: red blisters, typically in groups
  • contagious? yes
25
Q

which antiviral drug is primarily prescribed for HSV, is less active against VZV, and can be administered oral, IV, or topical?

A

acyclovir

26
Q

which antiviral drug is converted to acyclovir and should be administered orally only

A

valacyclovir

27
Q

which antiviral drug is used for orofacial or genital HSV-related sores and should be administered topically only due to poor oral absorption?

A

penicyclovir

28
Q

which antiviral drug is metabolized to pencyclovir, is mainly used for VZV infections (shingles), and should be administered orally only (overcomes poor absorption of peniciclovir)?

A

famcyclovir

29
Q

what is the efficacy for VZV of valacyclovir, acyclovir, and famcyclovir?

A

famciclovir >/= valacyclovir >>> acyclovir

30
Q

patients must always hydrate well while on any ___ drug to avoid ___

A
  • -cyclovir
  • crystalline nephropathy
31
Q

which 2 antivirals are used to treat HSV and/or cytomegalovirus (CMV) infections?

A

gancyclovir and foscarnet

32
Q

the following adverse effects are indicative of what antiviral?

due to its high risk of cytotoxicity, it must be administered in a clinical setting and monitored closely

A

gancyclovir

33
Q

what are the contraindications of gancyclovir?

A
  • during pregnancy - teratogenic and mutagenic
  • in males who wish to have children - inhibits spermatogenesis
34
Q

___ is much safer than gancyclovir and is useful in acyclovir- or gancyclovir- resistant HSV or CMV infections

A

foscarnet

35
Q

what is the method of action of foscarnet?

A

selectively inhibits viral DNA polymerase enzymes (not kinases)

36
Q

unlike acyclovir and gancyclovir, ___ is not activated by viral kinases. that is why it is useful in acyclovir- and gancyclovir- resistant HSV and CMV infections

A

foscarnet

37
Q

foscarnet should be administered via ___ only

A

IV

38
Q

what is the main adverse effect of foscarnet?

A

reversible nephrotoxicity

39
Q

___ is available by prescription for prophylaxis or treatment of influenza A and B viruses

A

oseltamivir (tamiflu)

40
Q

oseltamivir (tamiflu) is a ___ inhibitor

A

neuroaminidase

41
Q

why is early administration of oseltamivir crucial?

A
  • when a 5 day course of treatment is initiated within 48 hours from onset of flu symptoms, the duration of flu symptoms are decreased by up to 1-2 days
42
Q

what is the main adverse effect of oseltamivir (tamiflu)?

A

disulfuram-like reactions

43
Q

what is the clinical use of zanamivir (relenza)?

A

for the treatment and prophylaxis of influenza A and B

44
Q

what is the mechanism of zanamivir (relenza)?

A

neuroaminidase inhibitor

45
Q

___ is available as an inhaler only

A

zanamivir (relenza)

46
Q

what are the side-effects of zanamivir (relenza)?

A

disulfuram-like reactions

47
Q

___ is contraindicated in patients with severe asthma, COPD, or allergies to milk proteins. deep inhalation of the drug can induce bronchospasm and has been associated with rare deaths in patients with poorly controlled asthma and/or COPD

A

zanamivir (relenza)

48
Q

___ is only active against influenza A (not active against B)

A

amantadine

49
Q

amantadine is a ___ drug historically used as an antiviral for influenza A

A

anti-parkinson’s disease

50
Q

what are the two basic mechanisms of amantadine?

A

antiviral and anti-PD

51
Q

amantadine is no longer used as an antiviral due to ___

A

nearly 100% resistance of influenza A

52
Q

the following adverse effects are common to what antiviral?

ataxia, dizziness, anxiety, slurred speech

A

amantadine

53
Q

the following are contraindications of what antiviral?

patients with renal impairment, epilepsy, closed angle glaucoma, or during pregnancy

A

amantadine

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