Pharm-Antivirals Flashcards by Matt McCulloch

Q

Acyclovir indications

A

Shingles, Chicken pox

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Q

Cidofovir indications

A

Pox, HHV6-8

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Q

Famciclovir indications

A

Shingles and HHV8 (Z8)

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Q

Foscarnet indications

A

HHV6

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Q

Ganciclovir indications

A

HHV6, HHV8

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Q

Valacyclovir indications

A

Shingles, chicken pox, HHV8

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Q

Valganciclovir indications

A

HHV6, HHV8 infection

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Q

Pox virus family treatment options

A

cidofovir

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Q

Varicella treatment options

A

acyclovir, valacyclovir

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Q

Chicken pox treatment options

A

Acyclovir, valacyclovir

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Q

HHV6 treatment options

A

Cidofovir, foscarnet, ganciclovir, valganciclovir

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Q

HHV7 treatment options

A

Cidofovir

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Q

HHV8 treatment options

A

ganciclovir, valacyclovir

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Q

HHV8 infection treatment options

A

Ganciclovir, valganciclovir

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Q

Which two drugs are prodrugs

A

Valacyclovir, valganciclovir

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Q

Which drug is metabolized to another active drug

A

Famciclovir to penciclovir

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Q

What are the two main mechanisms of action for these drugs

A

Competes with deoxyGTP or with deoxyCTP for incorporation into viral DNA

Q

Which drugs competes with deoxyCTP

A

Cidofovir

Q

Which drug also inhibits reverse transcriptases?

A

Foscarnet

Q

Acyclovir MOA

A

competitive inhibitor of DNA pol as a deoxyGTP analog

Q

Famciclovir MOA

A

competitive inhibitor of DNA pol as a deoxyGTP analog

Q

Ganciclovir MOA

A

competitive inhibitor of DNA pol as a deoxyGTP analog

Q

Valacyclovir MOA

A

competitive inhibitor of DNA pol as a deoxyGTP analog

Q

Valganciclovir MOA

A

competitive inhibitor of DNA pol as a deoxyGTP analog

Q

Cidofovir MOA

A

competitive inhibitor of DNA pol as a deoxyCTP analog

Q

Foscarnet MOA

A

competitive inhibitor of pyrophosphate binding site of DNA pol, making triphosphates unusable; also blocks reverse transcriptase

Q

Which drugs do not require sequential phosphorylation to triphosphate form for activation?

A

Cidofovir and foascarnet

Q

What is the significance of requiring triphosphorylation to active form?

A

Viruses lacking kinases will fail to alter drug to active form

Q

Describe the meta/elim of the antivirals

A

Mostly unchanged; renal elimination thus requiring dose adjustment

Q

Describe the cross-reaction hypersensitivity of the antivirals?

A

Allergic to one, allergic to all!

Q

Which drug has the mildest AEs?

A

Famciclovir (everybody loves family values)

Q

Acyclovir AEs

A

Neurotoxic inc seizure (makes you go crACY)

Q

Cidofovir AEs

A

Nephrotoxic; give with probenecid and hydration to minimize

dose-dependent renal tubular necrosis (proximal tubule cell injury) beginning as soon as the first one or two doses

Q

Famciclovir AEs

A

none…

Q

Foscarnet AEs

A

Electrolytes - specifically chelates Ca2+ (FosCA2+rnet)

Q

Ganciclovir AEs

A

Anemia, pancytopenia or indiv cell line, teratogenic

Q

Valacyclovir AEs

A

Same as acyclovir, neurotoxicity w/ seizure

Q

Valganciclovir AEs

A

Same as ganciclovir, anemia, pancytopenia or indiv cell line, teratogenic

Q

These two drugs are neurotoxic

A

(CR)ACYclovir & ValACYclovir

Q

These two drugs cause anemia, pancytopenia, and are teratogens

A

Ganciclovir & Valganciclovir