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Pharmacology Exam 4 > Exam 4 - Anti-Virals (except HIV) > Flashcards

Exam 4 - Anti-Virals (except HIV) Flashcards

1
Q

Anti-Herpes/CMV

DRUG LIST

A
  • acyclovir
  • ganciclovir
  • foscarnet
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2
Q

Anti-Hepatitis

DRUG LIST

A
  • interferons
  • ribavirin
  • simepravir
  • sofosbuvir
  • ledipasvir/sofosbuvir
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3
Q

Anti-influenza

DRUG LIST

A
  • amantadine
  • oseltamavir
  • zanamivir
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4
Q

Anti-Herpes
acyclovir
mechanism

A
  • nucleoside analog (guanosine)
  • 1st phosphorylation done by virus (viral thymidine kinase)
  • acyclovir has specificity for viral thymidine kinase
  • DNA synth inhibition (chain termination)
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5
Q

Anti-herpes
acycolvir
TX targets

A
  • HSV 1/2, VZV

- in vitro activity against EBV, CMV, HHV6

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6
Q

Anti-herpes
acyclovir
ADME

A
  • low bioavailability (take w/ food)
  • oral, iv, topical
  • renal clearance
  • higher dose needed for VZV
  • long-term suppression of genital HSV, VZV
  • prodrome intervention for orolabial HSV
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7
Q

Anti-herpes
acyclovir
toxicities

A
  • well tolerated

- nausea, diarrhea

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8
Q

Anti-herpes
acyclovir
resistance

A

-mutation of viral thymidine kinase gene

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9
Q

Anti-CMV
ganciclovir
mechanism

A
  • pretty much identical to acyclovir

- 100x more effective against CMV than acyclovir

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10
Q

Anti-CMV
ganciclovir
administration

A

IV, intraocular (retinitis)

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11
Q

Anti-CMV
ganciclovir
indications

A
  • prophylaxis post transplantation
  • Kaposi’s sarcoma prophylaxis (AIDS)
  • CMV-induced retinitis, colitis, esophagitis, pneumonitis
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12
Q

Anti-CMV
ganciclovir
toxicities

A

myelosuppression, carcinogenic

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13
Q

Anti-CMV
ganciclovir
resistance

A

-mutation of viral thymidine kinase gene

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14
Q

Anti-herpes/CMV
foscarnet
mechanism

A
  • pyrophosphate analog
  • inhibits Viral DNA and RNA polymerases
  • 100x greater affinity for viral DNA pol
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15
Q

Anti-herpes/CMV
foscarnet
administration

A

IV only

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16
Q

Anti-herpes/CMV
foscarnet
indictations

A
  • ayclovir resistant herpes
  • CMV retinitis (co-rx w/ acyclovir)
  • VZV (off-label)
17
Q

Anti-herpes/CMV
foscarnet
toxicities

A
  • renal toxicity
  • hyperphospatemia, hypo-calcemia/kalemia/magnesemia
  • chromosome damage, seizurex, arrhythmias
18
Q

Antihepatitis

Classes

A

1) Ribavirin
2) PEG interferon
3) HCVProtease Inhibs (Simeprevir)
4) HCV Polymerase Inhibs (Sofosbuvir/Ledipasvir)

19
Q

Antihepatitis
PEG interferons
mechanism

A

-PEG increases half-life/bioavailability
-binds interpheron alpha receptor
-induces intracell signal to inhibit viral genome
tranlation/trancription/release
-increases MHC complex antigens
-stims macrophages
-CD8 T cell proliferation

20
Q

Antihepatitis
PEG interferons
adminstration

A

SC or IM

21
Q

Antihepatitis
PEG interferons
toxicities/adverse

A

-flu-like symptoms (“patients will hit you” - O’Brien),

elevation of hepatic enzymes

22
Q

Antihepatitis
PEG interferons
contraindications

A

-liver dz, autoimmune dz, arrhythmia, pregancy (abortifacient)

23
Q

Antihepatitis
Ribavirin
mechanism

A
  • guanosine analog

- blocks capping of viral mRNA

24
Q

Antihepatitis
Ribavirin
administration

A

oral pro-drug

25
Q

Antihepatitis
Ribavirin
tocixities/adverse

A

-hemolytic anemia occurs in 15% pts

26
Q

Antihepatitis
Ribavirin
contraindications

A

-teratogenic, embryotoxic, mutagenic

27
Q

Antihepatitis
Simeprevir
mechanism

A

-protease inhibitors (NS3/4A)

28
Q

Antihepatitis
Simeprevir
toxicities

A

-rash, photosens, bilirubinemia

29
Q

Antihepatitis
Simeprevir
contraindications

A
  • prolly preggercy

- rosuva/atorvastatin

30
Q

Antihepatitis
Sofosbuvir
mechanism

A
  • uridine analog
  • inhibits RNA polymerase
  • combo with PEG and ribavirin (likely exclude PEG soon)
  • probably to be combo’d with ledipsavir alone soon
31
Q

Antihepatitis
Sofosbuvir
toxicities

A
  • well tolerated

- side effects hard to separate from PEG/rib

32
Q

Antihepatitis
Sofosbuvir
contraindications

A

-rifampin

33
Q

Antiinfluenza
adamantanes
mechanism

A

-inhibit uncoating of viral RNA

34
Q

Antiinfluenza
adamantanes
contraindications

A
  • Parkinson’s

- high viral resistance

35
Q

Antiinfluenza
oseltamivir/zanamivir
mechanism

A
  • neuramidase inhibitors (sialic acid analogs)

- sialic acid necessary for viral release

36
Q

Antiinfluenza
oseltamivir/zanamivir
indications

A
  • influenza A/B
  • zanamivir for oseltamivir resistant strains
  • oseltamivir for 1yo+
  • zanamivir for 7yo+

Pharmacology Exam 4 (10 decks)

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