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Pharm 4 > Non-HIV antivirals > Flashcards

Non-HIV antivirals Flashcards

1
Q

Acyclovir MOA

A

2-deoxyguanosine analog; blocks NA synthesis

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2
Q

Acyclovir uses

A

Oral, IV, topical for HSV and VZV

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3
Q

Acyclovir metabolism and ADRs

A 
Poor oral availability, short half-life
renal excretion (reduce dose in renal failure)
ADR: GI upset and HA, renal nephropathy d/t crystallization in tubules, pregnancy cat B
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4
Q

Valacyclovir

A

Oral prodrug of acyclovir for HSV, VZV
*better oral availability
pregnancy cat B

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5
Q

Famciclovir

A

oral prodrug of penciclovir

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6
Q

penciclovir

A

similar to ganciclovir

topical only for herpes labialis

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7
Q

nucleoside analogs used for CMV

A

ganciclovir

valganciclovir

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8
Q

ganciclovir

A

analog of nucleoside guanosine

given IV, MOA and metabolism like acyclovir

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9
Q

ADR ganciclovir

A

bone marrow suppression (50%), renal nephropathy, fever, HA

preg cat C

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10
Q

valganciclovir

A

prodrug of ganciclovir

oral; achieves same plasma level as IV ganciclovir

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11
Q

foscarnet

A

pyrophosphate analog that reversibly binds viral DNA polymerase
to treat CMV; alternative for HSV, resistant HSV, VZV

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12
Q

foscarnet metabolism and ADR

A

IV d/t poor oral availability; renal clearance proportional to creatinine clearance
ADR: renal tubular toxicity and crystallization (saline loading needed), seizures, hypocalcemia (binds free Ca), genital ulceration d/t high conc in urine

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13
Q

Cidofovir

A

monophosphate nucleotide analog of deoxycitidine (dCTP) for CMV in HIV patients unresponsive to ganciclovir or foscarnet tx

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14
Q

cidofovir metabolism & ADR

A

No viral kinase req for phosphorlyation
IV d/t poor oral availability
*Must give probenecid and saline before and after infusion to prevent renal tubular secretion and toxicity
ADR: nephrotoxicity and neutropenia

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15
Q

treatment strategies for HBV

A

life-long therapy to sustain suppression of HBV replication to slow progression of hepatic complications; no eradication

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16
Q

First-line therapy for HBV

A

nucleotide/side analogs that inhibit DNApol and cause viral DNA chain termination
Tenofovir, entecavir

17
Q

tenofovir

A

1st line for HBV, also used for HIV
nucleotide/side analog
ADR: GI things (diarrhea, pain, etc.)

18
Q

entecavir

A

1st line for HBV

nucleotide/side analog

19
Q

Second-line therapy for HBV

A

interferon alfa

peginterferon alfa-a2

20
Q

Interferon alfa

A

second line therapy for HBV

21
Q

peginterferon alfa-a2

A

second line therapy for HBV, first line for HCV

pegylated prep of interferon alfa with increased half life = less frequent dosing

22
Q

ADR of second line therapy for HBV

A

flu-like syndrome common, bone marrow suppression, psychiatric disturbances

23
Q

treatment strategies for HCV

A

eradicate HCV in 24 weeks (genotypes 2,3) or 48 weeks (1; 79% cases)

24
Q

first-line therapy for HCV

A

types 2,3: peginterferon alfa-a2a or 2b + oral ribavirin

type 1: add teleprivir or boceprivir (protease inhibitors)

25
Q

ribavirin ADR

A

can cause severe hemolytic anemia

26
Q

teleprivir/ boveprivir

A

first line therapy for HCV type 1 in combination with peginterferon alfa + ribavirin
protease inhibitors

27
Q

sofosbuvir

A

nucleotide analog RNA pol inhibitor
prodrug activated in liver
used for chronic HCV in combo with ribavirin (2,3) or ribavirin + peginterferon (type 1)
*well-tolerated

28
Q

oseltamivir/ zanamivir

A

neuraminidase inhibitors for influenza types A and B prophylaxis and treatment (if give w/i 36 hours of sx onset) for adults and kids

29
Q

MOA of amantadine/ rimantadine

A

block M2 protein to inhibit uncoating of influenza A virus

30
Q

amantadine use and metabolism

A

for influenza A prophylaxis and treatment; high resistance now
used as adjunct therapy for PD
90% renal elimination

31
Q

amantadine ADR

A

Mild: anxiety, insomnia, difficulty concentrating
Severe: delirium, hallucinations, seizures

32
Q

rimantadine

A

for influenza A prophylaxis and treatment; high resistance now

Pharm 4 (8 decks)

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