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Pharmacology > Exam 8: Antivirals > Flashcards

Exam 8: Antivirals Flashcards

1
Q

Gamma Globulin Mechanism

A

Prevent attachment and penetration of viral particles

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2
Q

Gamma globulin adverse effects?

A

Systemic anaphylaxis

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3
Q

Pavilizumab

A

Monoclonal Antibody to RSV

Used in high risk infants by IV administration

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4
Q

Amantidine Mechanism

A

Blocks the M2 viral protein and causes buffering of the endosomal pH, preventing viral penetration and uncoating

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5
Q

Amantidine Uses (2)

A
  1. Influenza A Respiratory tract illness (Not effective against B)
  2. Also used as an Antiparkinsonian agent
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6
Q

What surface Antigens are used to type Influenza?

A

Hemagglutinin
Neuraminidase
(example: H1N1)

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7
Q

What is Neuraminidase important for?

A

A cleavage reaction required for release of virions from infected cells

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8
Q

What is Hemagglutinin important for?

A

Attachment of the virus to silica acid residues on the cell (important for penetration

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9
Q

Zanamivir mechanism

A

Inhibits neuraminidase of Influenza virus

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10
Q

Zanimivir uses

A

Influenza A and B

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11
Q

Oseltamivir Mechanism

A

Inhibits neuraminidase of Influenza virus

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12
Q

What is the difference between Zanamivir and Oseltamivir?

A

Oseltamivir can be taken orally and reaches places other than the respiratory tract.

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13
Q

Ribavirin Mechanism

A

Purine analog

Inhibits viral RNA synthesis

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14
Q

Ribavirin Uses (2)

A
  1. RSV in infants and young children

2. Chronic Hepatitis C (with IFN alpha)

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15
Q

Ribavirin Adverse Effects

A

Teratogenic

Pregnant healthcare workers should avoid caring for patients receiving aerosolized Ribavirin

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16
Q

Trifluridine Mechanism

A 
Pyrimidine analog (Thymidine)
Inhibits viral DNA synthesis
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17
Q

Trifluridine Uses

A

HSV1 and 2

Used topically for HSV keratoconjunctivitis or keratitis

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18
Q

Trifluridine Adverse Effects

A

Teratogenic

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19
Q

Acyclovir Mechanism

A

Purine Analog derived from Guanine
Must be phosphorylated to be active (done by Herpes’ intrinsic Tyrosine Kinase)
Inhibits viral DNA polymerase

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20
Q

How is Acyclovir selective?

A

It must be activated by a viral Tyrosine kinase.

Makes it non toxic to normal human cells

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21
Q

What is a problem with Acyclovir use?

A

Resistance is starting to occur.

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22
Q

Acyclovir uses

A

IV against Herpes viruses (all kinds of manifestations)
Topical agains mucocutaneous and keratitis caused by herpes
Also taken orally for VZV and herpes in the immunocompromised

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23
Q

Gancyclovir Uses

A

Cytomegalovirus retinitis

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24
Q

Gancyclovir Adverse effects (3)

A
  1. Teratogenic and carcinogenic
  2. Granulocytopenia, thrombocytopenia
  3. Myelosuppression
25
Q

Foscarnet mechanism

A

Inhibits Viral DNA polymerase

26
Q

Foscarnet use

A

used for cytomegalovirus retinitis in AIDS patients!

27
Q

Foscarnet advise effect

A

Renal Toxicity

28
Q

Name 3 Hep B drugs

A

Lamivudine
Tenofovir
Emtricitabine

29
Q

Interferon Alpha Mechanism

A

Alarm Molecule
Signals neighboring cells to prepare to defend themselves form viral infection.
Cells produce enzymes that inhibit viral transcription, translation, protein processing, and virus maturation.

30
Q

Interferon alpha uses

A
  1. Cutaneous warts
  2. Herpes keratoconjunctavitis
  3. Hepatitis B and C (+ribavirin)
  4. Also some cancers (bladder, karposi, hairy cell lymphoma)
31
Q

Interferon alpha adverse effects

A 
mild/moderate
flu like syndrome
muscle pain
NV
etc.
32
Q

What are 5 nucleoside reverse transcriptase inhibitors?

A 
Zidovudine
Didanosine
Lamivudine
Abacavir
Emtricitabine
33
Q

Name 1 nucleotide reverse transcriptase inhibitor

A

Tenofovir

NucleoTide–Tenofovir

34
Q

Name 1 non-nucleoside reverse transcriptase inhibitor

35
Q

Name 5 Protease Inhibitors

A 
Ritonavir
Indinavir
Nelfinavir
Lopinavir
Atazanavir
*** They all end in NAVIR
36
Q

Zidovudine Mechanism

A

Nucleoside Reverse Transcriptase Inhibitor (causes chain termination, inhibition of viral replication)

37
Q

Zidovudine Pharmacokinetics

A

Good CNS penetration

38
Q

Zidovudine Adverse Effects (2)

A
  1. GI disturbances

2. Bone marrow Toxicity

39
Q

What drug is used to prevent transmission of HIV from mother to child?

A

Zidovudine

40
Q

What is a major use of Zidovudine?

A

To prevent transmission of HIV from mother to child

41
Q

Didanosine Mehcanism

A

Nucleoside Reverse Transcriptase Inhibitor (causes chain termination, inhibition of viral replication)

42
Q

Didanosine Adverse Effects (3)

A
  1. Peripheral Neuropathy
  2. Pancreatitis
  3. GI effects
43
Q

Lamivudine Mechanism

A

Nucleoside Reverse Transcriptase Inhibitor (causes chain termination, inhibition of viral replication)

44
Q

Lamivudine Advantage

A

Less toxic than other drugs

Also treats Hep B

45
Q

Abacavir mechanism

A

Nucleoside Reverse Transcriptase Inhibitor (causes chain termination, inhibition of viral replication)

46
Q

How do non nucleoside RTIs work?

A

they bind directly to the reverse transcriptase enzyme and inhibit its activity

47
Q

Emtricitabine Mechanism

A

Nucleoside Reverse Transcriptase Inhibitor (causes chain termination, inhibition of viral replication)

48
Q

Emtricitabine Adverse effect

A

Pigmentation of palms of hands and soles of feet

49
Q

Tenofovir Mechanism

A

NucleoTide Reverse Transcriptase Inhibitor (causes chain termination, inhibition of viral replication)

50
Q

Tenofovir use besides HIV

51
Q

What is a pharmacokinetic interaction with non nucleoside RTIs?

A

p450 metabolism

52
Q

Efavirenz

A

Non nucleoside RTI
metabolized by p450
Cause headache, rash, insomnia
Also can cause neural tube defects

53
Q

Adverse effects of Ritonavir

A

NVD

Paresthesias

54
Q

Use of Ritonivir

A

Boost serum concentrate of other PIs

55
Q

Adverse effect of Indinavir

A

Nephrolithiasis

56
Q

Nelfinavir adverse effects

A

GI problems

57
Q

What are the preferred PIs for naive patients?

A

Ritonavir boosted Atazanavir

58
Q

What are the preferred NRTI treatments for naive patients? (2)

A
  1. Abacavir/Lamivudine

2. Emtricitabine/Tenofovir

Pharmacology (34 decks)

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