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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
Q

Use: Abacavir, Zidovudine

A

HIV

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26
Q

Use: Lamivudine, Emtricitabine, Tenofovir

A

HIV and HBV

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27
Q

Side effects: Lamivudine (Epivir); Emtricitabine (Emtriva)

A

Headache; N & V; rash; neutropenia; pancreatitis

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28
Q

Side effects: Efavirenz

A

• CNS symptoms!!
-vivid dreams
-drowsiness
• Teratogenic

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29
Q

Side effects: Nevirapine

A

Rash;

Hepatitis including hepatic necrosis

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30
Q

Side effects: Etravirine

A

Rash;

Increased LFTs

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31
Q

Side effects: Rilpivirine

A

Rash;

QT prolongation

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32
Q

Class: Efavirene;
Nevirapine;
Rilpivirine;
Etravirine

A

NNRTIs

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33
Q 
MOA: NNRTIs
Efavirene;
Nevirapine; 
Rilpivirine;
Etravirine
A

Inhibit reverse transcriptase through direct enzyme inhibition instead of a nucleoside base

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34
Q 
Use: NNRTIs
Efavirene;
Nevirapine; 
Rilpivirine;
Etravirine
A

HIV

35
Q

Side effects: Protease Inhibitors

A

GI intolerances - N/V, diarrhea;
Dyslipidemia;
Hyperglycemia;
Lipodystrophy

36
Q

Class:Ritonavir (Norvir);

A

Protease inhibitor

37
Q

Class: Fosamprenavir

A

Protease inhibitor

38
Q

Class: Atazanavir

A

Protease inhibitor

39
Q

Class: Darunavir

A

Protease inhibitor

40
Q

Class: Lopinavir

A

Protease inhibitor

41
Q

MOA: Protease inhibitors

A

Prevent cleavage of protein chain into functional subunits

42
Q 
Use: Protease inhibitors
Ritonavir
Fosamprenavir
Atazanavir
Darunavir
Lopinavir
A

HIV

43
Q

T/F: Resistance can develop slowly with use of protease inhibitors.

A

True

44
Q 
These drugs belong to what class and are used to treat HIV:
Ritonavir
Fosamprenavir
Atazanavir
Darunavir
Lopinavir
A

Protease inhibitors

45
Q

Side effects: Enfuvirtide

A

Local injection sight reaction (pain, erythema, induration, nodules, and cysts)
Increased rate of bacterial pneumonia
Hypersensitivity reaction

46
Q

Class: Enfuvirtide

A

Entry inhibitor (also its MOA)

47
Q

Class: Maraviroc

A

CCR5 antagonist (entry inhibitor)

Must test to see if virus is using CCR5 before administration

48
Q

Use: Enfuvirtide, Maraviroc

A

HIV

49
Q

How is Enfuvirtide administered?

A

Injectable

50
Q

Side effects: Maraviroc

A

Hepatotoxicity - rare;

Cough, fever, upper RTIs, Rash, musculoskeletal symptoms, abdominal pain, dizziness

51
Q

HIV often uses what co-receptors for entry into T-cells?

A

Chemokine (C-C motif) receptor 5 (CCR5) AND CXCR4

Maraviroc inhibits CCR5, no inhibitor exists yet for CXCR4.

52
Q

Class: Raltegravir

A

HIV Integrase inhibitor

53
Q

Class: Elvitegravir

A

HIV Integrase inhibitor

54
Q

Class: Dolutegravir

A

HIV Integrase inhibitor

55
Q

What is the function of HIV integrase?

A

Inserts viral DNA into human genome

56
Q

MOA: HIV Integrase inhibitors
Raltegravir;
Elvitegravir;
Dolutegravir

A

Binds to HIV integrase to prevent viral DNA strand transfer

57
Q

Use:
Raltegravir;
Elvitegravir;
Dolutegravir

A

HIV

58
Q

Side effects: HIV Integrase inhibitors

A

Headache;

Low side effect profile

59
Q

What are the common combinations for HAART?

A
  1. Integrase inhibitor + 2 NRTIs
  2. PI (+/- Ritonavir boosting) + 2NRTIs
  3. NNRTI and 2 NRTIs
60
Q

Class: Sofosbuvir

A

NS5B Polymerase Inhibitor

61
Q

Class: Paritapevir

A

NS5B Polymerase Inhibitor

62
Q

MOA: NS5B Polymerase Inhibitors (Sofosbuvir, Paritapevir)

A

Compete with viral nucleotide to cause viral chain termination of HCV RNA

63
Q

Use: Sofosbuvir, Paritaprevir

A

HCV

64
Q

Side effects: Sofosbuvir, Paritaprevir

A

Few side effects; fatigue, headache, anemia possible

65
Q

Class: Ledipasvir

A

NS5A inhibitor

66
Q

Class: Daclatasvir

A

NS5A inhibitor

67
Q

Class: Ombitasvir

A

NS5A inhibitor

68
Q

What is the function of NS5A in HCV?

A

NS5A is a viral phosphoprotein required for viral replication.

69
Q

Use: Ledipasvir; daclatasvir; ombitasvir

A

HCV

70
Q

MOA: Simeprevir; Bocepravir; Telapravir

A

Prevent viral maturation through the inhibition of protein synthesis

NS3/4A protease inhibitors

71
Q

Use: Simeprevir; Bocepravir; Telapravir

A

HCV

72
Q

Side effects: Simeprevir; Bocepravir; Telapravir (NS3/4A protease inhibitors)

A

Anemia, rash, itching, GI side effects

73
Q

Class: Simeprevir

A

NS3/4A protease inhibitors

74
Q

Class: Bocepravir

A

NS3/4A protease inhibitors

75
Q

Class: Telapravir

A

NS3/4A protease inhibitors

76
Q

Are HCV treatments typically given in combination?

A

YES

For example:
Sofosbuvir + Ledipasvir;
Simeprevir + Sofosbuvir;
Ombitasvir + Paritaprevir + Ritonavir

77
Q

Drug therapy for treatment of influenze should be started when?

A

Early in the course of the disease, otherwise the clinical benefits are limited

78
Q

Class: Oseltamivir

A

Neuraminidase inhibitor

79
Q

Class: Zanamivir

A

Neuraminidase inhibitor

80
Q

Class: Peramivir

A

Neuraminidase inhibitor

81
Q

MOA: Neuraminidase inhibitors - Oseltamivir, Zanamivir, Peramivir

A

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
Q

What is the route of administration of Zanamivir?

A

Inhaled therapy

83
Q

Side effects: Neuraminidase inhibitors - Oseltamivir, Zanamivir, Peramivir

A

Neuropsychiatric toxicity has been reported, GI side effects, brochospasm with zanamivir

MS 2 - Unit 6 (34 decks)

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