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Pharm 313 > Non HIV Antivirals > Flashcards

Non HIV Antivirals Flashcards

1
Q

How does a virus replicate?

A
  • must attach to host

- uses host cell energy to synthesize protein, RNA, DNA

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2
Q

Any drugs kills a virus may also kill….

A
  • our own cells b/c the virus is living in our cell

- for this reason viruses are hard to treat

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3
Q

What are the 2 major types of influenza?

A

A and B

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4
Q

Which surface antigens are on influenza?

A

surface antigen H (hemagglutinin) and N (neuraminidase)

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5
Q

what do the terms antigenic drift and antigenic shift refer to?

A 
drift = slight change in flu antigens
shift = major change in flu antigens
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6
Q

What are the 2 most common strains of influenza?

A

H1N1 and H3N2

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7
Q

How is the flu transmissed?

A

Droplet

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8
Q

Sxs from flu?

A
  • onset 2-4 days post exposure

- fever, chills, sore throat, headache, myalgia

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9
Q

3 options for dealing with flu transmission and spread? which is best?

A
  • prevention (best)
  • treat sxs
  • antiviral meds
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10
Q

what are the 3 types of flu vaccine?

A
  1. inactivated influenza vaccine (IFV)
  2. recombinant hemagglutinin vaccine (RIV)
  3. live, attenuated influenza vaccine
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11
Q

Which type of flu vaccine is most commonly distributed?

A

Inactivated Influenza Vaccine

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12
Q

Which vaccine is grown in a chicken egg?

A

Inactivated influenza vaccine

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13
Q

Who should not get the live, attenuated influenza vaccine?

Why?

A
  • <2 year old
  • immunocompromised, someone who lives with someone immunocompromised
  • don’t want’ people to get sick from virus in vaccine
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14
Q

Best to vaccinate for flu?

A

Early! Oct/November

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15
Q

Flu vaccine is recommended for _____ and older. Ages ______ need 2 vaccines 1 month apart

A

6 month, 2-8 year

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16
Q

When do you get immunity from an influenza vaccine and how long does it last?

A

2 weeks, last 6 months

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17
Q

If you have an egg allergy which which type of vaccine should you get?

A

Recombinant hemagglutinin vaccine

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18
Q

What are injection reaction side effects? What do they mean?

A
  • soreness, fever, myalgia, malaise

- IMMUNE SYSTEM RXN- not actally getting the flu

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19
Q

Severe and rare side effect to influenza vaccine?

A

Guillain-Barre

  • reversible weakness/paralysis
  • more associated with active flu
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20
Q

How man cases of anaphylaxis in 2016 study of influenza vaccine?

A

10!

-can give egg vaccine (IFV) to someone who has egg allergy

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21
Q

How long do you monitor after the vaccine for an allergic rxn?

A

15 minutes

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22
Q

What is Oseltamivir/Tamiflu?

A

prophylaxis and treatment for influenza

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23
Q

How long does immunity last with tamiflu?

A

10 days

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24
Q

Who is given prophylaxis Tamiflu?

A

-congregate living setting residents to prevent spread

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25
How does Tamiflu work?
-neuroaminidase inhibitor: prevents budding of viral particles from infected host cells (can't duplicate)
26
When should you take Tamiflu for treatment?
- no >2 days after exposure | - best response if taken with 12 hours of sxs
27
Adverse effects from Tamiflu?
Nausea, vomiting | rare: Stevens Johnson, neuropsych effects in young
28
How long can Tamiflu be used for prophylaxis in outbreaks?
up to 10 days
29
Tamiflu and Live attenuated vaccine- whats the deal?
discontinue Tamiflu 48 hours prior to getting LAIV
30
Which hepatitis come from body fluids, blood, and sperm?
B,C,D
31
Which hepatitis come from lack of food hygiene and contaminated water?
A, E
32
Which hepatitis does not have a vaccine?
C
33
Which type of hepatitis is most likely to go on to carrier state and is leading cause of liver transplant?
C
34
When do you treat for Hep B?
treatment not needed unless active liver disease
35
Hep B patients are often co-infected with what?
Hep D or HIV
36
What is the treatment for Hep B?
- not great options and they are hard to tolerate (interferon alpha) - resistance common - many same drugs for active HIV - best option is prevent with vaccine!
37
Treatment for Hep C is based on the patient's....
genotype
38
What is the protocol to treat Hep C?
combination therapy to prevent resistance and increase success
39
Cure rates for treating Hep C? Duration of treatment?
cure rates = 95-99% | duration 8-12 weeks
40
Adverse effects from Hep C treatment
- nausea, fatigue, weakness | - monitor liver function
41
Drug drug interactions with Hep C treatment
- antacids - lipid lowering meds - anti-seizure - retroviral
42
HSV1=
cold sores
43
HSV2=
genital, STI
44
HSV 3=
Varicella Zoster virus (shingles/chickenpox) | -dormant and reemerge
45
HSV4=
Epstein Bar Virus | -mononucleosis, Burkitt Lymphoma
46
HSV5=
cytomegalovirus | -retinitis, pulmonary, GI
47
HSV6=
roseola
48
HSV7=
HSV 7
49
HSV8=
Karpsosi's Sarcoma (KSV)
50
drug of choice to treat HSV 1/2 and varicella zoster virus?
Acyclovir
51
How does Acyclovir work?
- inhibits viral replication by suppressing synthesis of viral DNA - virus has to activate the drug in order to work
52
Do you use Acyclovir prophylatically or for treatment?
both! | prophylaxis and treatment
53
Acyclovir routes of admin
oral, topical, IV (immunocompromised)
54
Is acyclovir safe for pregnancy?
yes
55
Adverse effects from acyclovir? | from IV?
-GI distress, headache, vertigo | IV:phlebitis, reversible nephrotoxicity (hydrate well to prevent)
56
Frequency of administration for Acyclcovir?
``` IV= over 1 hour Oral= 3-5 times/day ```
57
What is the prodrug of acyclovir?
Valacyclovir
58
Why would you want to take valacyclovir over acyclovir?
1. Bioavailability of valacyclovir is 55% > then acyclovir (-once converted to acyclovir, kinetics are the same) 2. Better compliance only take 1 or 2 times / day
59
Valacyclovir prophylaxis or treatment?
Both
60
Why would you want to take acyclovir instead of valacyclovir?
1. valacyclovir costs 4X more | 2. risk for immunocompromised to develop TTP/HUS with valacyclovir
61
what is are TTP and HUS?
- thrombotic thrombocytopenia purpua - hemolytic urea syndrome = rare side effects in immunocompromised from valacyclovir
62
What are some topical therapies for Herpes Labialis? Do they work?
- acyclovir - penciclovir - Docosanol (abreva) - does not work as well as oral therapy. - studies should <1/2 day of improved healing time
63
Side effects of topical treatments for herpes labialis?
stinging
64
Considerations for applying topical meds for herpes labialis?
wear finger cot or gloves
65
Herpes labialis- when it is it transmissable?
-viral shedding and transmission occurs when lesions are not present but more likely to transmit when lesions are present
66
Which patient populations are we particularly concerned about getting CMV?
-transplant, immunocompromised, pregnant women (birth defects)
67
What is the leading cause of birth defects?
CMV infection
68
How is CMV spread and how long do you have it?
- direct contact with body fluids | - remain dormant for life (50-85% >40 years have CMV virus)
69
CMV can manifest in what organ system cause problems?
eyes --> CMV retinitis causes vision loss
70
Is CMV a problem for healthy people?
If immune system is intact then CMV is not a real problem
71
How do you treat CMV?
Ganciclovir or Valganciclovir
72
What is valganciclovir and why would you take it?
prodrug of ganciclovir which prevents and treats CMV | -bioavailability of 60% compared to ganciclovir's 9%
73
How do Ganciclovir/Valganciclovir work?
suppress replication of viral DNA
74
Serious side effects from valganciclovir/ganciclovir? (3)
- Bone Marrow Suppression: decrease RBC/WBC/Platelets - Reproductive toxicity/Mutagenesis: no preg 90 days post treatment - carcinogenesis: precautions for nurse handling * hazardous drug packaging
75
Common side effects Ganciclovir/Valganciclovir?
GI distress, fever, headache (valganciclovir)
76
Ganciclovir/Valganciclovir Route of administration
- oral - iv - occular implants/gel for occular HSV
77
IV Ganciclovir/Valganciclovir admin?
infuse over 1 hour!*

Pharm 313 (26 decks)

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