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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
Q

How does Tamiflu work?

A

-neuroaminidase inhibitor: prevents budding of viral particles from infected host cells (can’t duplicate)

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26
Q

When should you take Tamiflu for treatment?

A
  • no >2 days after exposure

- best response if taken with 12 hours of sxs

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27
Q

Adverse effects from Tamiflu?

A

Nausea, vomiting

rare: Stevens Johnson, neuropsych effects in young

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28
Q

How long can Tamiflu be used for prophylaxis in outbreaks?

A

up to 10 days

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29
Q

Tamiflu and Live attenuated vaccine- whats the deal?

A

discontinue Tamiflu 48 hours prior to getting LAIV

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30
Q

Which hepatitis come from body fluids, blood, and sperm?

A

B,C,D

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31
Q

Which hepatitis come from lack of food hygiene and contaminated water?

A

A, E

32
Q

Which hepatitis does not have a vaccine?

A

C

33
Q

Which type of hepatitis is most likely to go on to carrier state and is leading cause of liver transplant?

A

C

34
Q

When do you treat for Hep B?

A

treatment not needed unless active liver disease

35
Q

Hep B patients are often co-infected with what?

A

Hep D or HIV

36
Q

What is the treatment for Hep B?

A
  • 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
Q

Treatment for Hep C is based on the patient’s….

A

genotype

38
Q

What is the protocol to treat Hep C?

A

combination therapy to prevent resistance and increase success

39
Q

Cure rates for treating Hep C? Duration of treatment?

A

cure rates = 95-99%

duration 8-12 weeks

40
Q

Adverse effects from Hep C treatment

A
  • nausea, fatigue, weakness

- monitor liver function

41
Q

Drug drug interactions with Hep C treatment

A
  • antacids
  • lipid lowering meds
  • anti-seizure
  • retroviral
42
Q

HSV1=

A

cold sores

43
Q

HSV2=

A

genital, STI

44
Q

HSV 3=

A

Varicella Zoster virus (shingles/chickenpox)

-dormant and reemerge

45
Q

HSV4=

A

Epstein Bar Virus

-mononucleosis, Burkitt Lymphoma

46
Q

HSV5=

A

cytomegalovirus

-retinitis, pulmonary, GI

47
Q

HSV6=

A

roseola

48
Q

HSV7=

A

HSV 7

49
Q

HSV8=

A

Karpsosi’s Sarcoma (KSV)

50
Q

drug of choice to treat HSV 1/2 and varicella zoster virus?

A

Acyclovir

51
Q

How does Acyclovir work?

A
  • inhibits viral replication by suppressing synthesis of viral DNA
  • virus has to activate the drug in order to work
52
Q

Do you use Acyclovir prophylatically or for treatment?

A

both!

prophylaxis and treatment

53
Q

Acyclovir routes of admin

A

oral, topical, IV (immunocompromised)

54
Q

Is acyclovir safe for pregnancy?

A

yes

55
Q

Adverse effects from acyclovir?

from IV?

A

-GI distress, headache, vertigo

IV:phlebitis, reversible nephrotoxicity (hydrate well to prevent)

56
Q

Frequency of administration for Acyclcovir?

A 
IV= over 1 hour
Oral= 3-5 times/day
57
Q

What is the prodrug of acyclovir?

A

Valacyclovir

58
Q

Why would you want to take valacyclovir over acyclovir?

A
  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
Q

Valacyclovir prophylaxis or treatment?

A

Both

60
Q

Why would you want to take acyclovir instead of valacyclovir?

A
  1. valacyclovir costs 4X more

2. risk for immunocompromised to develop TTP/HUS with valacyclovir

61
Q

what is are TTP and HUS?

A
  • thrombotic thrombocytopenia purpua
  • hemolytic urea syndrome

= rare side effects in immunocompromised from valacyclovir

62
Q

What are some topical therapies for Herpes Labialis? Do they work?

A
  • acyclovir
  • penciclovir
  • Docosanol (abreva)
  • does not work as well as oral therapy.
  • studies should <1/2 day of improved healing time
63
Q

Side effects of topical treatments for herpes labialis?

A

stinging

64
Q

Considerations for applying topical meds for herpes labialis?

A

wear finger cot or gloves

65
Q

Herpes labialis- when it is it transmissable?

A

-viral shedding and transmission occurs when lesions are not present but more likely to transmit when lesions are present

66
Q

Which patient populations are we particularly concerned about getting CMV?

A

-transplant, immunocompromised, pregnant women (birth defects)

67
Q

What is the leading cause of birth defects?

A

CMV infection

68
Q

How is CMV spread and how long do you have it?

A
  • direct contact with body fluids

- remain dormant for life (50-85% >40 years have CMV virus)

69
Q

CMV can manifest in what organ system cause problems?

A

eyes –> CMV retinitis causes vision loss

70
Q

Is CMV a problem for healthy people?

A

If immune system is intact then CMV is not a real problem

71
Q

How do you treat CMV?

A

Ganciclovir or Valganciclovir

72
Q

What is valganciclovir and why would you take it?

A

prodrug of ganciclovir which prevents and treats CMV

-bioavailability of 60% compared to ganciclovir’s 9%

73
Q

How do Ganciclovir/Valganciclovir work?

A

suppress replication of viral DNA

74
Q

Serious side effects from valganciclovir/ganciclovir? (3)

A
  • 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
Q

Common side effects Ganciclovir/Valganciclovir?

A

GI distress, fever, headache (valganciclovir)

76
Q

Ganciclovir/Valganciclovir Route of administration

A
  • oral
  • iv
  • occular implants/gel for occular HSV
77
Q

IV Ganciclovir/Valganciclovir admin?

A

infuse over 1 hour!*

Pharm 313 (26 decks)

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