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MS 2 - Unit 6 > Pharmacology - Antiviral Therapy I and II > Flashcards

Pharmacology - Antiviral Therapy I and II Flashcards

1
Q

Class: Acyclovir; Penciclovir

A

Purine analog (guanosine)

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2
Q

Class: Valacyclovir; Famciclovir

A

Purine analog (guanosine)

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3
Q

MOA: Valacyclovir; Famciclovir

A

Prodrug converted to Acyclovir & Penciclovir,respectively –> After phosphorylation, causes viral DNA chain termination

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4
Q

MOA: Acyclovir; Penciclovir

A

After phosphorylation, causes viral DNA chain termination

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5
Q

Class: Ganciclovir

A

Purine analog (guanine)

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6
Q

MOA: Ganciclovir

A

After phosphorylation, causes viral DNA chain termination

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7
Q

Class: Foscarnet

A

Pyrophosphate congener

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8
Q

MOA: Foscarnet

A

Directly inhibits HSV DNA polymerase or HIV reverse transcriptase

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9
Q

Use: Foscarnet

A

Broad spectrum (HSV/VZV/CMV, and RNA viruses including HIV)

use for resistant strains only due to toxicity concerns

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10
Q

Use: Ganciclovir

A

Treatment & prophylaxis of CMV infection (but also HSV, VZV)

**Valganciclovir for PO bc of much higher bioavailabiltiy

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11
Q

Use: Valacyclovir; Famciclovir;

Acyclovir; Penciclovir

A

HSV, VZV (requires higher dose than HSV)

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12
Q

Side effects: Valacyclovir; Famciclovir;

Acyclovir; Penciclovir

A

CNS changes and renal dysfunction possible when used at higher doses

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13
Q

Side effects: Ganciclovir

A

Neutropenia, thrombocytopenia

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14
Q

Side effects: Foscarnet

A

Dose-dependent renal and CNS toxicities, electrolyte & metabolic abnormalities;
Myelosuppression

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15
Q

What specific scenario is Foscarnet recommended for?

A

Used for invasive HSV/VZV infections from acyclovir resistant strains; alternative to ganciclovir for CMV

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16
Q

Side effects: Tenofovir

A

Nephrotoxicity;
Lactic acidosis;
GI issues

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17
Q

Side effects: Abacavir

A

Hypersensitivity reaction;
Lactic acidosis;
GI issues

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18
Q

Side effects: Zidovudine

A

Anemia;
Granulocytopenia
Lactic acidosis;
GI issues

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19
Q

Class: Zidovudine

A

NRTI

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20
Q

Class: Lamivudine (Epivir); Emtricitabine (Emtriva)

A

NRTI

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21
Q

Class: Tenofovir

A

NRTI

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22
Q

Class: Abacavir

A

NRTI

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23
Q

Class:
Efavirenz (Sustiva);
Nevirapine (Viramune); Rilpivirine (Edurant);
Etravirine (Intelence)

A

NNRTI

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24
Q 
MOA: NRTIs
Zidovudine;
Lamivudine;
Emtricitabine;
Tenofovir;
Abacavir
A

Inhibits reverse transcriptase

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25
Use: Abacavir, Zidovudine
HIV
26
Use: Lamivudine, Emtricitabine, Tenofovir
HIV and HBV
27
Side effects: Lamivudine (Epivir); Emtricitabine (Emtriva)
Headache; N & V; rash; neutropenia; pancreatitis
28
Side effects: Efavirenz
• CNS symptoms!! -vivid dreams -drowsiness • Teratogenic
29
Side effects: Nevirapine
Rash; | Hepatitis including hepatic necrosis
30
Side effects: Etravirine
Rash; | Increased LFTs
31
Side effects: Rilpivirine
Rash; | QT prolongation
32
Class: Efavirene; Nevirapine; Rilpivirine; Etravirine
NNRTIs
33
``` MOA: NNRTIs Efavirene; Nevirapine; Rilpivirine; Etravirine ```
Inhibit reverse transcriptase through direct enzyme inhibition instead of a nucleoside base
34
``` Use: NNRTIs Efavirene; Nevirapine; Rilpivirine; Etravirine ```
HIV
35
Side effects: Protease Inhibitors
GI intolerances - N/V, diarrhea; Dyslipidemia; Hyperglycemia; Lipodystrophy
36
Class:Ritonavir (Norvir);
Protease inhibitor
37
Class: Fosamprenavir
Protease inhibitor
38
Class: Atazanavir
Protease inhibitor
39
Class: Darunavir
Protease inhibitor
40
Class: Lopinavir
Protease inhibitor
41
MOA: Protease inhibitors
Prevent cleavage of protein chain into functional subunits
42
``` Use: Protease inhibitors Ritonavir Fosamprenavir Atazanavir Darunavir Lopinavir ```
HIV
43
T/F: Resistance can develop slowly with use of protease inhibitors.
True
44
``` These drugs belong to what class and are used to treat HIV: Ritonavir Fosamprenavir Atazanavir Darunavir Lopinavir ```
Protease inhibitors
45
Side effects: Enfuvirtide
Local injection sight reaction (pain, erythema, induration, nodules, and cysts) Increased rate of bacterial pneumonia Hypersensitivity reaction
46
Class: Enfuvirtide
Entry inhibitor (also its MOA)
47
Class: Maraviroc
CCR5 antagonist (entry inhibitor) Must test to see if virus is using CCR5 before administration
48
Use: Enfuvirtide, Maraviroc
HIV
49
How is Enfuvirtide administered?
Injectable
50
Side effects: Maraviroc
Hepatotoxicity - rare; | Cough, fever, upper RTIs, Rash, musculoskeletal symptoms, abdominal pain, dizziness
51
HIV often uses what co-receptors for entry into T-cells?
Chemokine (C-C motif) receptor 5 (CCR5) AND CXCR4 Maraviroc inhibits CCR5, no inhibitor exists yet for CXCR4.
52
Class: Raltegravir
HIV Integrase inhibitor
53
Class: Elvitegravir
HIV Integrase inhibitor
54
Class: Dolutegravir
HIV Integrase inhibitor
55
What is the function of HIV integrase?
Inserts viral DNA into human genome
56
MOA: HIV Integrase inhibitors Raltegravir; Elvitegravir; Dolutegravir
Binds to HIV integrase to prevent viral DNA strand transfer
57
Use: Raltegravir; Elvitegravir; Dolutegravir
HIV
58
Side effects: HIV Integrase inhibitors
Headache; | Low side effect profile
59
What are the common combinations for HAART?
1. Integrase inhibitor + 2 NRTIs 2. PI (+/- Ritonavir boosting) + 2NRTIs 3. NNRTI and 2 NRTIs
60
Class: Sofosbuvir
NS5B Polymerase Inhibitor
61
Class: Paritapevir
NS5B Polymerase Inhibitor
62
MOA: NS5B Polymerase Inhibitors (Sofosbuvir, Paritapevir)
Compete with viral nucleotide to cause viral chain termination of HCV RNA
63
Use: Sofosbuvir, Paritaprevir
HCV
64
Side effects: Sofosbuvir, Paritaprevir
Few side effects; fatigue, headache, anemia possible
65
Class: Ledipasvir
NS5A inhibitor
66
Class: Daclatasvir
NS5A inhibitor
67
Class: Ombitasvir
NS5A inhibitor
68
What is the function of NS5A in HCV?
NS5A is a viral phosphoprotein required for viral replication.
69
Use: Ledipasvir; daclatasvir; ombitasvir
HCV
70
MOA: Simeprevir; Bocepravir; Telapravir
Prevent viral maturation through the inhibition of protein synthesis NS3/4A protease inhibitors
71
Use: Simeprevir; Bocepravir; Telapravir
HCV
72
Side effects: Simeprevir; Bocepravir; Telapravir (NS3/4A protease inhibitors)
Anemia, rash, itching, GI side effects
73
Class: Simeprevir
NS3/4A protease inhibitors
74
Class: Bocepravir
NS3/4A protease inhibitors
75
Class: Telapravir
NS3/4A protease inhibitors
76
Are HCV treatments typically given in combination?
YES For example: Sofosbuvir + Ledipasvir; Simeprevir + Sofosbuvir; Ombitasvir + Paritaprevir + Ritonavir
77
Drug therapy for treatment of influenze should be started when?
Early in the course of the disease, otherwise the clinical benefits are limited
78
Class: Oseltamivir
Neuraminidase inhibitor
79
Class: Zanamivir
Neuraminidase inhibitor
80
Class: Peramivir
Neuraminidase inhibitor
81
MOA: Neuraminidase inhibitors - Oseltamivir, Zanamivir, Peramivir
Inhibits an enzyme critical in penetration of respiratory tract mucus and in the release of virus from infected cells Effective against influenza A and B
82
What is the route of administration of Zanamivir?
Inhaled therapy
83
Side effects: Neuraminidase inhibitors - Oseltamivir, Zanamivir, Peramivir
Neuropsychiatric toxicity has been reported, GI side effects, brochospasm with zanamivir

MS 2 - Unit 6 (34 decks)

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