Pharm 37 Viral Infections Flashcards
1
Q
Maraviroc
A
- Inhibits viral attachment by blocking chemokine receptor CCR5.
- HIV
- Can cause rash , dizziness, URI, fever
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.
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
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.
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
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)
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.
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.
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)
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)
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
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
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.
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
15
Q
Fomivirsen
A
- Antisense nucleotide, binds to mRNA
- CMV retinitis (second line)