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pharmacology lecom sh > Pharm 37 Viral Infections > Flashcards

Pharm 37 Viral Infections Flashcards

1
Q

Maraviroc

A
  • Inhibits viral attachment by blocking chemokine receptor CCR5.
  • HIV
  • Can cause rash , dizziness, URI, fever
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2
Q

Enfuvirtide (T-20)

A
  • Inhibits viral entry by binding gp41 and preventing fusion of HIV envelope with host cell
  • HIV
  • Administered parenterally 2x/day.
    Can cause Guillain-Barre syndrome.
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3
Q

Amantadine

Rimantadine

A
  • Inhibits viral uncoating: blocks M2, a protein channel that acidifies the interior of the virus. Virus cannot leave cell.
  • Influenza A, Parkinsons (amantadine)
  • Can cause neuroleptic malignant syndrome and exacerbate mental disorders
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4
Q

Acyclovir

Valacyclovir

A
  • Nucleoside and nucleotide analogues: Phosphorylated by viral thymidine kinases, leads to inhibition of viral DNA polymerase. Chain terminators. Pro-drugs.
  • HSV, VZV
  • Can cause renal failure when administered IV.
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5
Q

Penciclovir

Famcyclovir

A
  • Nucleoside and nucleotide analogues: Phosphorylated by viral thymidine kinases, leads to inhibition of viral DNA polymerase. Chain terminators. Pro-drugs.
  • HSV, VZV
  • Can cause erythema multiforme
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6
Q

Ganciclovir

Valganciclovir

A
  • Nucleoside and nucleotide analogues: Phosphorylated by viral thymidine kinases, leads to inhibition of viral DNA polymerase. Chain terminators. Pro-drugs.
  • CMV
  • Bone marrow suppression (pancytopenia)
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7
Q

Cidofovir

A
  • Nucleoside and nucleotide analogues: Phosphorylated by cellular enzymes then inhibits DNA polymerase
  • CMV retinitis
  • Co-administer with probenecid to dec nephrotoxicity.
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8
Q 
Zidovudine (AZT)
Stavudine (d4T)
Zalcitabine (ddC)
Lamivudine (3TC)
Emtricitabine (FTC)
Didanosine (ddI)
Acabavir (ABC)
A
  • Nucleoside and nucleotide analogues: Phosphorylated by cellular kinases then inhibit viral reverse transcriptase (NRTIs), Anti-HBV inhibit HBV polymerase.
  • HIV, HBV (lamivudine)
  • Cause bone marrow suppression (AZT is most toxic, 3TC is least toxic), FTC once daily. ABC is RARELY used due to fatal hypersensitivity. Pancreatitis and peripheral neuropathy is common.
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9
Q

Tenofovir
Adefovir
Entecavir

A
  • Nucleoside and nucleotide analogues: Phosphorylated by cellular kinases then inhibit viral reverse transcriptase (NRTIs), Anti-HBV inhibit HBV polymerase.
  • HIV (tenofovir), HBV (adefovir, entecavir)
  • hepatotoxicity (tenofovir), renal toxicity (adeforvir)
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10
Q

Foscarnet

A
  • Nonnucleoside DNA polymerase inhibitor: inhibit viral DNA polymerase directly by mimicking the pyrophosphate product of the rxn.
  • HSV (acyclovir resistant strains), CMV
  • Does not cause bone marrow suppression. Does not need to be activated by Thymidine Kinase. Renal impairment is the major dose-limiting toxicity - ATN and Ca wasting. Can’t use with pentamidine (treats P. jirovice)
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11
Q

Efavirenz
Nevirapine
Delavirdine
Etravirine

A
  • Nonnucleoside reverse transcriptase inhibitors (NNRTIs): bind near the catalytic site of reverse transcriptase and prevent the enzyme from joining deoxyribonucleotides with the primer-template strand.
  • HIV
  • Efavirenz: dysphoric dreams and insomnia
    Nevirapine: given to pregnant woman and decreases the chance of vertical transmission.
    All: rash and P450 3A4 drugs are contraindicated. resistance develops rapidly
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12
Q

Raltegravir

A
  • Inhibits viral integration: inhibits integrase, blocking integration of HIV into the cellular genome
  • HIV
  • Only used in combo with other drugs
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13
Q

Saqinavir
Ritonavir
Idinavir
….navir

A
  • Protease Inhibitors: block viral integration, HIV virons bud from the cell but these are not infective. Pol encoded genes.
  • HIV
  • Cause weight gain, dyslipidemia (less with atazanavir). Can’t use with P450 3A4.
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14
Q

Zanamivir

Oseltamivir

A
  • Inhibit viral release: inhibit viral neuraminidase causing newly made virons to remain attached to the host cell.
  • Influenza A and B
  • Zanamivir via inhaler (respiratory aggravation). Not used a lot due to side effects being flu-like
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15
Q

Fomivirsen

A
  • Antisense nucleotide, binds to mRNA

- CMV retinitis (second line)

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16
Q

Ribavirin

A
  • Decrease GTP levels, inhibits viral RNA polymerase

- RSV (aerosol), HCV (w/ interferon-a)

17
Q

Docosanol

A
  • HSV coldsores
18
Q

Interferon-alpha

A
  • Modulate immune system: increases protein kinase R which turn off host translational machinery in virus infected cells
  • HCV, HBV, Kaposi’s sarcoma, CML, hairy cell leukemia, malignant melanoma, renal cell carinoma
19
Q

Imiquimod

A
  • Interacts with TLR to boost innate immunity, inc interferons.
  • HPV, Basal cell CA, actinic keratosis.
  • Wash hands before and after application

pharmacology lecom sh (24 decks)

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