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PF3012 > Pharmacology of Anti-Virals > Flashcards

Pharmacology of Anti-Virals Flashcards

1
Q

List the 4 types of DNA viruses

A

Herpes viruses (glandular fever, chickenpox, shingles, cold sores)
Pox viruses (smallpox)
Adenoviruses (sore throat, conjunctivitis)
Papillomaviruses (warts)

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2
Q

How many human herpes viruses are there?

A

8

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3
Q

Which 3 of the herpes viruses are neurotropic?

A

HHV-1/HSV-1
HHV-2/HSV-2
HHV-3/VZV

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4
Q

Which 3 herpes viruses are lymphotropic?

A

HHV-4/EBV
HHV-5/ CMV
HHV-6/7
HHV-8

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5
Q

How many types of seasonal influenza viruses are there?

A

4 - A, B, C, D

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6
Q

Which influenza viruses cause the seasonal epidemics?

A

A and B

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7
Q

What categories is influenza A broken down into?

A

Classified according to combinations of HA (haemagglutinin) and NA (neuraminidase) proteins on the surface of the virus

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8
Q

Which 2 categories are viral DNA polymerase inhibitors broken into?

A

nucleoside analogues
non-nucleoside analogues

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9
Q

give examples of nucleoside analogues (DNA polymerase inhibitors)

A

acyclovir, ganciclovir, valaciclovir
(prodrugs)

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10
Q

give examples of non-nucleoside analogues (DNA polymerase inhibitors)

A

foscarnet
cidofovir

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11
Q

give examples of M2 inhibitors

A

amantadine
rimantadine

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12
Q

give examples of neuraminidase inhibitors

A

oseltamivir
zanamivir

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13
Q

Which amino acid are the viral dna inhibitors nucleotide analogues mimicking?

A

guanine

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14
Q

How does acyclovir work?

A

Acyclovir is activated by the enzyme viral thymidine kinase to acyclovir monophosphate
Further phosphorylated by cellular enzymes to triphosphate form (ACV-TP)
This fake building block inhibits viral DNA polymerase leading to chain termination
Only actively replicating viruses are inhibited

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15
Q

Does viral DNA polymerase or cellular DNA polymerase have a higher affinity for ACV-TP or

A

viral dna polymerase has a 10-30 fold greater affinity for ACV-TP

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16
Q

Which viruses does acyclovir treat mostly?

A

HHV1, HHV2, VZV
less so for EBV or CMV

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17
Q

Indications and side effects of topical application of acyclovir

A

Limited, non life threatening mucocutaneous HSV infections
SE: local irritation, funny taste in the mouth

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18
Q

Indications and side effects of oral acyclovir

A

Primary genital herpes, HSV suppression
SE: nausea, diarrhea, headache

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19
Q

Indications and side effects of IV acyclovir

A

Severe HSV infection, HSV encephalitis, VZV infection in immunocompromised host
SE: sweating, rash, emesis, fall in BP

large doses can result in crystallisation in the renal tubules - hydration is important with higher doses

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20
Q

Does valaciclovir or acyclovir have higher serum levels

A

Valaciclovir

21
Q

MOA of valaciclovir

A

l-valine ester of acyclovir
serum esterases hydrolyse it to free acyclovir
available orally only

22
Q

What is ganciclovir used for?

A

treatment and prevention of CMV in immunocompromised patients
used IV - poor oral bioavailability

23
Q

What is the prodrug of Penciclovir?

A

Famciclovir - converted to penciclovir in the intestines and liver

24
Q

What is famciclovir most commonly used for?

A

Herpes zoster - shingles
available orally only

25
Q

SE of famciclovir

A

stomach upset
headache
mild fever

26
Q

What is the drug of choice in patients resistant to acyclovir?

A

Foscarnet
only available IV

27
Q

MOA of foscarnet

A

Non-nucleoside DNA analogue
Binds to a site on the herpesvirus DNA polymerase or HIV reverse transcriptase during viral replication
Interferes with the exchange of pyrophosphate from deoxynucleoside triphosphate

phosphorylation step is not required unlike the nucleoside analogues

28
Q

Which influenza is the M2 channel present on?

A

Influenza A only

29
Q

MOA of M2 inhibitors

A

Bind to M2 channel in the influenza A virus only
Prevents ion flux necessary to coat the endosome

30
Q

Which genes are resistant to M2 inhibitors

A

H5N1 (bird flu)
H1N1 (swine flu)

31
Q

When would you use an M2 inhibitor?

A

in patients at high risk for complications

32
Q

SE of amantadine?

A

dizziness
seizures

33
Q

What does neuraminidase do?

A

an enzyme found on the virus which cleaves sialic acid and allows for the more efficient release of the virus

34
Q

MOA of neuraminidase inhibitors

A

inhibit neuraminidase
cause newly formed virions to adhere to the cell surface and form viral aggregates and thus limit spread

35
Q

Are neuraminidase inhibitors effective against H5N1 and H1N1?

A

yes

36
Q

What is the roa of oseltamivir (tamiflu)

A

oral

37
Q

AE of tamiflu

A

headache

38
Q

When should oseltamivir be taken?

A

Within 48 hours of symptoms

39
Q

ROA of zanamivir (relenza)

A

inhalation

40
Q

AE of zanamivir (relenza)

A

bronchospasm
nasal and throat discomfort

41
Q

What are the 3 classes of interferons?

A

alpha - leukocytes
beta - fibroblasts
gamma - t-lymphocytes, NK cells

42
Q

What is interferon a used for?

A

hairy cell leukemia
kaposi’s sarcoma
chronic hepatitis b and c infection

43
Q

roa of interferon a

A

parenteral

44
Q

what is interferon b used for?

A

multiple sclerosis

45
Q

What is interferon gamma used for?

A

chronic granulomatous disease
hodgkin’s lymphoma

46
Q

adverse effects of ganciclovir?

A

haematological - granulocytopenia, neutropenia, anaemia, thrombocytopenia
fever
nausea
vomiting
carcinogenic
teratogenic
mutagenic

47
Q

adverse effects of interferon a

A

flu-like symptoms
alopecia
depression
hypotension
teratogenic

48
Q
A

PF3012 (10 decks)

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