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BMS 622 Exam 3 > Lecture 13: Antivirals, Herpes - Chap 40 43 > Flashcards

Lecture 13: Antivirals, Herpes - Chap 40 43 Flashcards

1
Q

What are the four phases of pharmacokinetics in drug processing?

A

Absorption, distribution, metabolism, excretion.

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2
Q

What is the function of reverse transcriptase inhibitors (RTIs) in antivirals?

A

They block the RNA-to-DNA conversion in retroviruses.

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3
Q

Which antiviral blocks HIV’s fusion with host cells?

A

Fuzeon, which blocks HIV-Gp41.

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4
Q

What is the mechanism of Amantadine in influenza treatment?

A

Blocks the M2 ion channel, inhibiting uncoating in the endosome.

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5
Q

What is a unique feature of interferon as an antiviral?

A

It activates immune responses but has severe side effects.

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6
Q

Which antiviral drug is known to inhibit neuraminidase in influenza?

A

Zanamivir and Oseltamivir (Tamiflu).

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7
Q

What is the primary action of protease inhibitors in HIV therapy?

A

Prevent cleavage of viral polyprotein, stopping assembly.

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8
Q

What is HAART, and why is it used in HIV treatment?

A

Highly Active Anti-Retroviral Therapy; it uses multiple drugs to reduce resistance.

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9
Q

What antiviral is commonly used to treat HSV and relies on viral thymidine kinase?

A

Acyclovir.

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10
Q

What virus types are treated with nucleoside analogs?

A

HSV, VZV, HBV, and HIV.

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11
Q

What is the mechanism of nucleoside analogs in viral inhibition?

A

They mimic natural nucleotides, causing chain termination in viral DNA.

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12
Q

How does HCV therapy with ribavirin and interferon-α improve cure rates?

A

By blocking RNA synthesis and enhancing immune response.

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13
Q

What is a common side effect of ribavirin that requires caution?

A

It is teratogenic, causing birth defects.

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14
Q

How does Epstein-Barr Virus (EBV) contribute to mononucleosis?

A

Through overactive immune responses against infected B cells.

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15
Q

What is a unique diagnostic feature of EBV infection?

A

Heterophile antibodies that agglutinate sheep RBCs.

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16
Q

What is the main treatment strategy for VZV reactivation (shingles)?

A

Nucleoside analogs like acyclovir, with higher doses than for HSV.

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17
Q

What are typical triggers for HSV reactivation?

A

UV light, stress, and immunosuppression.

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18
Q

Which virus uses latency in neurons and can cause recurrent infections?

A

HSV-1 and HSV-2.

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19
Q

How is EBV linked to certain cancers?

A

It can immortalize B cells, leading to lymphomas in immunocompromised individuals.

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20
Q

What antiviral drug class is used to inhibit the influenza virus’s release?

A

Neuraminidase inhibitors.

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21
Q

What are the common clinical uses of antiviral drug therapy for CMV?

A

Treatment of CMV pneumonitis and retinitis, especially in immunocompromised patients.

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22
Q

What differentiates VZV (chickenpox) spread from HSV?

A

VZV spreads through respiratory droplets, not direct contact alone.

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23
Q

Which herpesvirus is associated with “kissing disease”?

A

Epstein-Barr Virus (EBV).

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24
Q

How does CMV avoid immune detection?

A

By blocking MHC-I and MHC-II expression.

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25
Q

Which herpesvirus is most likely to cause congenital infection?

A

Cytomegalovirus (CMV).

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26
Q

What is the primary immune response required to control herpesvirus infections?

A

Cell-mediated immunity.

27
Q

What is a Tzanck smear used for?

A

Diagnosing HSV infections through identification of multinucleated giant cells.

28
Q

What unique feature does the live-attenuated varicella vaccine (Oka strain) target?

A

Prevention of primary VZV infection and herpes zoster (shingles).

29
Q

Why are immunocompromised individuals at higher risk for herpesvirus complications?

A

They lack sufficient T-cell response to control viral reactivation.

30
Q

What is the mechanism of action of famciclovir in treating herpesvirus?

A

It is a prodrug activated in the liver to inhibit viral DNA polymerase.

31
Q

What are the primary targets for antiviral drugs in the viral lifecycle?

A

Attachment, penetration, uncoating, synthesis, assembly, and release

32
Q

How does Acyclovir inhibit herpesvirus replication?

A

Acyclovir is a nucleoside analog that inhibits viral DNA polymerase, causing chain termination during DNA synthesis

33
Q

What is the mechanism of Tamiflu (oseltamivir) in influenza treatment?

A

Inhibits neuraminidase, preventing virus release from host cells and further infection

34
Q

Describe the role of interferons in antiviral treatment.

A

Interferons inhibit protein synthesis, promote RNA degradation, and enhance immune response; used for broad-spectrum antiviral effects

35
Q

What does pharmacokinetics refer to in antiviral drug treatment?

A

The movement of drugs within the body, including absorption, distribution, metabolism, and excretion

36
Q

Define pharmacodynamics in the context of antiviral drugs.

A

The effects of drugs on the body, focusing on efficacy, toxicity, and therapeutic index

37
Q

What are common side effects of ganciclovir?

A

Bone marrow suppression, anemia, and potential renal toxicity

38
Q

Describe the half-life of a drug.

A

The time it takes for the plasma concentration of a drug to reduce by half

39
Q

What is the therapeutic index?

A

The ratio between a drug’s effective dose and its toxic dose, indicating safety margin

40
Q

How does herpesvirus establish latency in host cells?

A

HSV establishes latency in neurons, while EBV establishes latency in B cells

41
Q

What triggers reactivation of latent herpesvirus?

A

Stress, UV light, immunosuppression, and fever can trigger reactivation

42
Q

What is the main transmission mode for herpes simplex virus (HSV)?

A

Direct contact with infected secretions, like saliva or genital secretions

43
Q

List the stages of the herpesvirus replication cycle.

A

Immediate early (α), early (β), and late (γ) gene expression, followed by DNA replication, assembly, and release

44
Q

Describe the pathogenesis of HSV in humans.

A

HSV causes direct cytopathic effects, evades immune response via cell-to-cell spread, and establishes latency

45
Q

What symptoms are associated with HSV-1 and HSV-2 infections?

A

Oral lesions (cold sores) for HSV-1, genital lesions for HSV-2, and potential complications like encephalitis

46
Q

How is varicella-zoster virus (VZV) transmitted?

A

Primarily via respiratory droplets; can also spread through contact with lesions

47
Q

What are common symptoms of primary varicella infection?

A

Fever, malaise, and a vesicular rash (chickenpox)

48
Q

What diagnostic method detects HSV in skin lesions?

A

Tzanck smear, showing multinucleated giant cells and Cowdry type A inclusions

49
Q

How is CMV commonly transmitted?

A

Through body fluids like saliva, urine, breast milk, and blood

50
Q

What antiviral drugs are commonly used for CMV?

A

Ganciclovir, valganciclovir, foscarnet, and cidofovir

51
Q

What type of immune response is crucial for controlling herpesvirus infections?

A

Cell-mediated immunity, particularly T-cell responses

52
Q

Describe how EBV infects and persists in the body.

A

EBV infects B cells, establishes latency, and can cause mononucleosis and malignancies in immunocompromised individuals

53
Q

What laboratory tests confirm EBV-induced infectious mononucleosis?

A

Heterophile antibody test, serology for EBV antigens, or PCR for viral DNA

54
Q

Explain the concept of drug resistance in antiviral therapy.

A

Mutations in viral targets, like polymerases or proteases, reduce drug efficacy by altering drug binding

55
Q

What is HAART and its purpose in HIV treatment?

A

Highly Active Antiretroviral Therapy; combines drugs to reduce viral load and prevent resistance

56
Q

Describe the mechanism of protease inhibitors in antiviral therapy.

A

Prevents cleavage of viral polyproteins, inhibiting virus assembly and maturation

57
Q

How does varicella-zoster virus differ in primary infection versus reactivation?

A

Primary infection causes chickenpox, while reactivation leads to shingles (zoster)

58
Q

Which antiviral drug class is commonly used for HIV?

A

Nucleoside reverse transcriptase inhibitors (NRTIs)

59
Q

How is HIV spread among individuals?

A

Through blood, sexual contact, and vertical transmission (from mother to child)

60
Q

What is the primary method to diagnose HSV encephalitis?

A

PCR testing of cerebrospinal fluid (CSF) for HSV DNA

61
Q

List the main antiviral drugs used for herpes simplex virus.

A

Acyclovir, valacyclovir, famciclovir, and penciclovir

62
Q

What is the function of the antiviral drug Amantadine?

A

Blocks the M2 ion channel of influenza, preventing uncoating

63
Q

Why is ganciclovir not recommended for pregnant women?

A

Risk of teratogenic effects and bone marrow suppression

64
Q

What is the mechanism of action of ribavirin?

A

Inhibits RNA synthesis and increases mutation rate in RNA viruses

BMS 622 Exam 3 (12 decks)

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