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36: Treatment of Viral Infections > questions > Flashcards

questions Flashcards

0
Q

T/F: antibiotics are not effective against viral infections

A

true

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1
Q

how do protease inhibitors work?

A

interfere with step eight of the HIV lifecycle.

-they blocked cleavage of long train viral proteins

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2
Q

what are some more serious adverse effects of nucleotide analogues?(2)

A
  1. nephrotoxicity

2. hepatitis may worsen on discontinuation

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3
Q

with the exception of ______, why are NNRTIs only used in combination with NRTIs and PIs?

A

nevirapine

-because resistance develops rapidly

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4
Q

penciclovir is administered ______.

A

topically

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5
Q

what 4 types of drugs are used for the treatment of viral hepatitis?

A
  1. nucleoside analogues
  2. interferons
  3. nucleotide analogues
  4. protease inhibitors
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6
Q

define: adherence

A

closely following or hearing to the treatment regimen

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7
Q

T/F: amantadine acts against influenza B but not influenza A

A

false.

acts against influenza A but not influenza B

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8
Q

zanamivir is not recommended for patients with __________.

A

pulmonary disease

-it has been reported to produce bronchospasm and deterioration in pulmonary function

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9
Q

when are HIV-infected patients diagnosed with AIDS?

A

when there CD4 cell count falls below 200 cells/mm3(cubed) or if they develop and AIDS defining illness

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10
Q

define: drug resistance testing

A

Laboratory test to determine whether an individual’s HIV strain is resistant to any anti-HIV medications

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11
Q

T/F: all nucleoside analogues are used in the treatment of HBV

A

false

all but ribavirin

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12
Q

________ is formulated for oral use and ________ is formulated as a powder for oral inhalation

A
  1. oseltamivir

2. zanamivir

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13
Q

________ are not technically antiviral agents.

A

interferons

-instead, they protect uninfected cells by promoting resistance to virus infection

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14
Q

define: antiviral

A

medication that is able to inhibit viral replication

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15
Q

what 8 drugs are protease inhibitors?

A
  1. fosamprenavir
  2. atazanavir
  3. darunavir
  4. indinavir
  5. nelfinavir
  6. ritonavir
  7. saquinavir
  8. tipranavir
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16
Q

nucleoside and nucleotide analogues are used to treat _____.

A

hepatitis B virus

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17
Q

what are possible side effects of NRTI’s?(9)

A 
liver problems
muscle inflammation and weakness
diabetes
abnormal fat distribution
high cholesterol
decreased bone density
skin rash
pancreatitis
leukopenia
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18
Q

______ are used for the treatment of hepatitis B virus and hepatitis C virus

A

interferons

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19
Q

define: antiretroviral

A

medication that interferes with the replication of retroviruses. (HIV is a retrovirus)

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20
Q

what drug has greater oral absorption and treats the same conditions as acyclovir, but requires less frequent dosing?

A

valacyclovir

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21
Q

penciclovir is an active metabolite of _________, and indicated for the treatment of herpes labialis (cold sore)

A

famciclovir

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22
Q

define: antiviral resistance

A

ability of a virus to overcome the suppressive of action of antiviral agents

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23
Q

____ is required to have a boxed warning in the package regarding reports of fatal and nonfatal intracranial hemorrhage

A

tipranavir

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24
Q

______ is an oral powder stable for six hours, once mixed with food or liquid (if refrigerated)

A

nelfinavir

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25
Q

define: CD4 count

A

number of CD4 cells in a sample of blood

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26
Q

what neuraminidase inhibitors are used in the treatment of influenza?(2-generic name)

A
  1. oseltamivir

2. zanamivir

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27
Q

what are common adverse reactions to acyclovir, famciclovir, ganiclovir, penciclovir and valacyclovir?(7)

A 
diarrhea
nausea
vomiting
headache
fatigue
dizziness
confusion
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28
Q

how do neuraminidase inhibitors work?

A

inhibit virus proliferation by blocking the virus release from the host cell. this limits the spread of the virus

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29
Q

what are the 3 important ways that NNRTIs differ from NRTIs?

A
  1. NNRTIs are noncompetitive inhibitors of reverse transcriptase
  2. they do not need to be activated by host enzymes
  3. they are not effective against HIV-2
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30
Q

define: cross resistance

A

development of resistance to one drug in a particular class that results in resistance to other drugs in that class

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31
Q

define: virion

A

infectious particles of a virus

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32
Q

what allergic reactions are associated with the use of drugs used in the treatment of influenza?(2)

A
  1. facial edema

2. oropharyngeal

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33
Q

what factors influence the outcome of antiviral therapy? (5)

A
  1. stage of illness
  2. dose of antiviral used
  3. ability of virus to penetrate the CNS
  4. ability of the virus to remain latent within the host
  5. development of antiviral resistance
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34
Q

what adverse reactions are associated with the use of telaprevir?

hint: 1, but detailed

A

DRESS

-DRESS symptoms include rash, fever, facial edema, hepatitis and nephritis.

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35
Q

what are some adverse effects of nucleotide analogues?(7)

A 
headache
abdominal pain
diarrhea
nausea
dyspepsia
flatulence
asthenia
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36
Q

PIs are administered as combination therapy; most are recommended to be given along with ______.

A

ritonavir

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37
Q

define: highly active antiretroviral therapy

A

combination of three or more antiretroviral medications taken in a regimen

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38
Q

T/F: foscarnet may produce hair loss, tinnitus, hearing loss, arrhythmias and heart failure

A

true

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39
Q

H1N1 and H3N3 are strains of influenza A that are susceptible to the effects of _______.

hint: classification

A

neuraminidase inhibitors

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40
Q

nausea and vomiting, coughing, dizziness, and headache are common side effects to the use of_______ and _____.

A
  1. oseltamivir

2. zanamivir

41
Q

what is neutropenia?

A

drop in white blood cell count

42
Q

define: host

A

individual infected with a virus

43
Q

________ interfere with ___ viral replication.

A
  1. protease inhibitors

2. hepatitis C virus (HCV)

44
Q

define: oncovirus

A

A virus that is a causative agent in cancer

45
Q

define: viral load

A

amount of materials from the virus that get released in the blood when the HIV reproduces.

46
Q

what are the six classes of antiretrovirals?

A
  1. nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs)
  2. nonnuclear side reverse transcriptase inhibitors (NNRTIs)
  3. protease inhibitors (PIs)
  4. fusion inhibitors
  5. chemokine receptor antagonist, type 5
  6. HIV integrase stand inhibitor
47
Q

define: virustatic

A

able to suppress viral proliferation

48
Q

define: virus

A

intracellular parasite that consists of a DNA and RNA core surrounded by a protein coat and sometimes an outer covering of lipoprotein

49
Q

what are the most common adverse reactions associated with interferons?

A

flulike symptoms:

fever, chills, headache, fatigue, muscle ache, and joint pain

50
Q

what are other adverse reactions caused by interferons?(5)

A 
nausea
vomiting
diarrhea
dizziness
depression
51
Q

_____ is indicated for the treatment of cytomegalovirus retinitis in patients with AIDS

A

cidofovir

52
Q

_____ may also produce the adverse reactions: irritation and discoloration of the skin

A

penciclovir

53
Q

______ is teratogenic and classified in pregnancy category D

A

efavirenz

54
Q

what are some common side effects of protease inhibitor: boceprevir(4)

A

fatigue
anemia
nausea
headache

55
Q

______ is indicated for the treatment of HBV and RSV.

A

ribavirin

56
Q

what are more serious adverse effects of raltegravir?(5)

A 
rhabdomyolysis
depression
suicidal ideation
thrombocytopenia
increased cancers
57
Q

entecavir is effective against _______-resistant HBV.

A

lamivudine

58
Q

what are too serious adverse effects associated with the use of interferons?

A
  1. drop in white blood cell count

2. drop in platelet count

59
Q

HAART is also known as _______

A

an AIDS cocktail

60
Q

_______ was the first available antiretroviral.

A

zidovudine

-introduced in 1987

61
Q

what is thrombocytopenia?

A

drop in platelet count

62
Q

what does DRESS stand for?

A

drug reaction with eosinophilia and systemic symptoms

63
Q

______ is effective against RNA and DNA viruses

A

ribavirin

64
Q

The most common adverse effects of entecavir and lamivudine are: (4)

A

headache
fatigue
dizziness
nausea

65
Q

what is HBV and HCV?

A

HBV- hepatitis B virus

HCV- hepatitis C virus

66
Q

what are some adverse reactions of protease inhibitors?

A
  • can elevate triglyceride, cholesterol, and blood glucose levels and insulin resistance.
  • cause redistribution of fat (accumulating in stomach, and loss in limbs and face)
67
Q

Tamiflu is indicated for the treatment of _______.

A

influenza

68
Q

what is an advantage and disadvantage of virus mutation?

A

advantage- may results in a virus that is not able to reproduce
disadvantage- often result in adaptations that make it easier for the virus to exist in new environments and hosts

69
Q

Side effects associated with almost all NRTIs are:(5)

A 
headache
stomach upset
fatigue or insomnia
muscle ache
diarrhea
70
Q

why is it difficult to develop a vaccine to prevent virus infection?

A

because viruses continually mutate.

for example, each year, a new vaccine must be developed for the latest strain of influenza

71
Q

what 2 drug classifications are used in the treatment of influenza?

A
  1. inhibitors of viral uncoating

2. neuraminidase inhibitors

72
Q

what inhibitor of viral uncoating is used in the treatment of influenza A?

A

amantidine

73
Q

define: human immunodeficiency virus

A

virus that causes acquired immunodeficiency syndrome

74
Q

define: AIDS

A

The most severe form of human immunodeficiency virus.

75
Q

T/F: proteins inhibitors produced nausea, vomiting, and diarrhea

A

true

76
Q

what does AIDS stand for?

A

acquired immunodeficiency syndrome

77
Q

what are the adverse allergic reactions to fusion inhibitors?(7)

A 
rash
chills
fever
stuffiness
hypertension
nausea
vomiting
78
Q

T/F: risk associated with nevirapine is greatest in the first 6 to 18 weeks of therapy, and more common in women than men

A

true

79
Q

what are the most common side effects of maraviroc?(5)

A 
colds
cough
fever
rash
dizziness
80
Q

define: mother to child transmission

A

transmission of the HIV from an HIV infected mother to her baby drink pregnancy, delivery, or through breastmilk (called perinatal transmission)

81
Q

define: CD4 T lymphocyte

A

White blood cells that fight infection

82
Q

psychosis and other emotional changes have been reported with the use of _________.

hint: classification

A

neuraminidase inhibitors

83
Q

what 7 drugs are NRTIs?

A
  1. abacavir
  2. didanosine
  3. emtricitabine
  4. lamivudine
  5. stavudine
  6. tenofovir
  7. zidovudine
84
Q

numerous drug interactions are seen when ______ are administered concurrently with benzodiazepines and proton pump inhibitors (-prazoles)

A

NNRTIs

86
Q

______ may be administered orally to pregnant women and intravenously during delivery and as a suspension to neonates.

A

zidovudine

  • should begin at 14 weeks of pregnancy
  • showing to reduce mother to child transmission of HIV
86
Q

what are the adverse effects of raltegravir?(4)

A

headache
dizziness
diarrhea
GI upset

87
Q

saquinavir should be taken ______.

A

with food

88
Q

to avoid the formation of kidney stones,______ should be taken with at least 1.5 L of water daily

A

indinavir

89
Q

which NRTI may cause nail discoloration?

A

zidovudine

90
Q

_______ may cause dizziness, drowsiness or insomnia, abnormal dreams, confusion, abnormal thinking, impaired concentration, amnesia, agitation, hallucinations, depersonalization, and euphoria

A

efavirenz

91
Q

what is a common ending for protease inhibitors(PIs)?

A

-navir

92
Q

what three drugs are classified as NNRTIs?

A
  1. delavirdine
  2. efavirenz
  3. nevirapine
93
Q

which NNRTI has a short half-life and must be given in multiple daily doses?

A

delavirdine

94
Q

what is pregnancy category D?

A

drug should not be administered in the first trimester of pregnancy and women taking the drug should be advised to avoid pregnancy

95
Q

what is a common side effect of all NNRTIs?

A

rash

96
Q

nevirapine is associated with _______ any FDA has required changes in the package labeling to warn of this adverse effect.

A

fatal liver toxicity

100
Q

what are some other adverse effects reported for maraviroc?(3)

A

myocardial infarction
hepatotoxicity
priest infections or cancers

102
Q

what is currently the only drug in the class fusion inhibitors?

A

enfuviritide

103
Q

how are fusion inhibitors administered?

A

must be administered by subcutaneous injection into the thigh, arm, or abdomen.

104
Q

what is the adverse reaction of fusion inhibitors?(5)

A 
irritation
pain
redness
itchiness
formation of nodules and cysts at site of injection

36: Treatment of Viral Infections (2 decks)

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