LEC 9 - Antiviral Agents + Targets Flashcards
What is the conventional approach to control of viral diseases?
Vaccines
What is the objective of antiviral drug therapy?
Eradicate virus
Minimally impact the host
Prevent further viral invasion
What are the problems that people run into when developing anti-virals?
Need to penetrate host cells
Narrow therapeutic margin
Viral latency issues affect efficacy
Susceptibility testing is challenging/costly
What is the common way to classify antiviral drugs?
Through their mechanism of action
What are the five types of antivirals?
Immunomodulators
Ion channel blockers
Neuraminidase inhibitors
DNA/RNA synthesis inhibitors
Antiretroviral
What is the basic way that ion channel blockers work?
Block uncoating
What types of drugs are in the group of immunomodulators?
Interferons
Interleukins
Growth factors
What is the most dominant immunomodulator?
Type 1 interferon
What type of activity foes type 1 interferons have?
Antiviral activity
Immunomodulatory effects
What is Feline interferon-omega used for?
Cats - FeLV + FIV
Dogs - Parvo virus
What are the ion channel blockers?
Amantadines
(Amantadine + Rimantadine)
What are the amatadines used for?
Influenza A viruses
How does ion channel blockers work?
Block uncoating step of the life cycle
Insert into M2 protein channel - no H+ enters
No M1 protein dissociation
Keeps viral RNA within protein coat
Whats the normal steps in viral uncoating?
Endosomal acidification
Active viral M2 channel protein - H+ enters virion
Viral M1 matrix protein dissociates = viral uncoating
What causes resistance to ion channel blockers?
Mutations in M2 protein
Widespread, no longer recommended for use
What drugs are in the neuraminidase inhibitor family?
Oseltamivir + Zanamivir
What are the neuraminidase inhibitors used for?
Influenze A + B
How do the neuraminidase inhibitors work?
Block the release of Influenze A + B from host cell membrane
Sialic acid analods
Bind to NA and prevent enzymatic acitivty
Inhibits viral release - can’t infect new cells
What is the normal events that occur when Influenza A or B are released from the host cell?
replication occurs
Virus buds from host cell
remains bound to sialic acid on host cell membrane
Viral NA cleaves virus from salic acid
Virus released
How does resistance to NA inhibitors occur?
Sporadic cases
Mutation in NA
What infections has NA inhibitors been recommended for in dogs?
Canine parvo infection
What are the types of antiviral agents that are considered DNA/RNA synthesis inhibitors?
Nuceloside synthesis inhibitor
Nucleoside analogs - DNA
Nucleoside analogs - RNA
Nucleoside + Non-nucleoside reverse transcriptase inhibitors
How do nucleoside synthesis inhibitors work?
Directly inhibit DNA/RNA polymerase activity
What are the nucleoside synthesis inhibitors?
Foscarnet
What are the two types of nucleoside analogs for DNA syntesis?
Purine + Pyrimidine
What are the purine analogs?
Acyclovir
What are the pyrimidine analogs?
Cidofovir
Idoxuridine
Trifluridine
What drugs are nucleoside analogs that interfere with viral RNA synthesis?
Ribavirin
How does foscarnet work?
Direct inhibition of DNA polymerase
Bind to pyrophosphate binding site
Prevent cleavage of pryophosphate
Halts DNA replication
What viruses does foscarnet work for?
Wide range
Herpesvirus
– and –
Retrovirus
What can cause resistance to foscarnet?
Mutations in viral DNA polymerase
How do nucleoside analogs work?
Inhibit viral DNA polyermase
Chain termination activity
Converted to triphosphate nucleotides in host cell
What viruses are the target for nucleoside analog treatment?
Herpesvirus
What is Acyvlovir a analog of?
dGTP
How does Acyclovir work?
Inhibits replication
ACV is converted to ACV-P by viral enzyme TK
Competitive inhibitor of viral polymerase
Higher affinity for DNA polymerase
How is Acyclovir selective?
Uninfected cells will not change ACV into ACV-P
How does resistance to Acyclovir occur?
Mutation in viral TK or DNA polymerase
What are the prodrug derivatives of Acyclovir?
Valacylovir
Famicilovir
Valganciclovir
What do all nucleoside analogs require?
Inital phosphorylation by virally-encoded enzymes
What is ACV + PCV phosphorlylated by?
TK
What is GCV phosphorylated by?
Viral Protein Kinase (PK)
How does Vidarabine work?
Interferes with viral DNA polymerase activity
How is vidarabine used in vet medicine?
FHV-1 ocular infections in cats
Topical use ONLY
What is cidofovir an analog of?
Deoxycytosine
How does Cidofovir work?
Inhibitiion of polymerase activity
Chain termination
How do viruses become resistant to Cidofovir?
Mutations in DNA polymerase
What does Cidofovir work against?
Herpes
Adeno
Poz
Papilloma
How can Cidofovir be used opthalmically?
Herpes eye infections in cats
What are the two forms of pyrimidine analogs?
Idoxuridine
Trifluridien
What is the structure of Idoxuridine?
Iodine atom added to a uracil
What is the structure of Trifluridine?
Contains -CF3 group added to Uracil
How are Pyrimidine analogs used?
Feline herpes eye infectiosn
What does Ribavirin resemble?
Purine analog
Resembles RNA nucleotides
How does Ribavirin work?
Immunomodulator - promote Th1 development
Inhibits IMPDH enzyme - stops GTP synthesis
Inhibits RNA-dependent RNA polymerase - RNA replication
Promotes mutagenesis
Interferes with mRNA capping
How does ribavirin promote mutagenesis?
Resemble both A + G bases
Incoporated into RNA
What does ribavirin work against?
Both RNA + DNA viruses
Works best against RNA respiratory viruses + Herpes
How does resistance to antiretroviral agents develope?
Mutations at or near drugs binding site
OR
Mutations that change the conformation of target protien
What is the antiretroviral used to treat FIV + FeLV?
AZT
in combination with type I interferon
How does Zifovudine work?
Selective inhibition of viral reverse transcriptase
What are the non-nucleoside RT inhibitors?
Efavirenz
Nevirapine
Delavirdine
How do the non-nucleoside RT inhibitors work?
Non-competively binding to reverse transcriptase + inhibiting its action
What are the fusion/entry inhibitors?
maraviroc
– and –
Enfuvirtide
How do the fusion/entry inhibitors work?
Interfere with receptor-mediated binding of virus to host
– or –
Prevent fusion of retroviral envelope with host cell membrane
What are the integrase inhibitors?
Raltegravir
– and –
Elvitegravir
How do integrase inhibitors work?
Inhibit integration of viral DNA into the host cell genome
What are the protease inhibitors?
Saquinavir
Ritonavir
Indinavir
How do the protease inhibitors function?
Binding to + inhibiting proteolytic activity of viral protease
Prevent cleavage of polypeptide into functional proteins