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Pulmonology > Sweatman: Viral Pneumonia therapy > Flashcards

Sweatman: Viral Pneumonia therapy Flashcards

1
Q

Markers suggestive of Viral Pneumonia

A

younger than five
ongoing viral epidemic
slow onset
rhinitis, wheezing

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2
Q

chest radiograph findings for intersititial

A

sole interstitial infiltrates bilaterally

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3
Q

blood markers for viral pneumonia

A

few white cells
little CRP
little pro-calcitonin in serum

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4
Q

tx of Influenza A and B

A

Oseltamvir, Zanamivir

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5
Q

prevention of Influenza A and B

A

vaccine, oseltamvir, zanamivir

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6
Q

Influenza A virus tx

A

amantadine PO, rimantidine PO

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7
Q

Hnumber refer to

A

hemagluttinin type

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8
Q

N# refers to

A

neuraminidase strain

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9
Q

Hemagluttinins allow for

A

binding of virus to sialic acid receptors and fusion with cell membrane to permit entry

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10
Q

neuraminidase function

A

bind the cell to the inner part of membrane and functions in release of the newly formed virion to infect other eukaryotic cells

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11
Q

Tx for RSV

A

ribavarin

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12
Q

prevention of RSV

A

palavizumab

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13
Q

palavizumab MOA

A

MAB that binds up F protein in RSV and prevents entry/attachment into host cell

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14
Q

indications for Palivizumab

A

neonates, infants with congenital heart defects, chronic lung disease and/or prematurity

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15
Q

tx of rhinovirus

A

none

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16
Q

prevention of rhinovirus

A

Alfa intereron

ribavarin (off label use)

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17
Q

tx for enteroviruses

A

none

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18
Q

preventions of enteroviruses

A

none

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19
Q

tx of metopneumovirus

A

ribavirin

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20
Q

prevention of metpneumovirus

A

none

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21
Q

tx of hantavirus

22
Q

prvention of hanta virus

23
Q

tx of varicella-zoster

A

acyclovir

valacyclovir

24
Q

prevention of vericella-zoster

25
Q

MOA for oseltamvir

A

Oseltamivir is a neuraminidase inhibitor, serving as a competitive inhibitor of neuraminidase (NA) enzyme upon sialic acid, –>prevents new viral particles from being released through the cleaving of terminal sialic acid on glycosylated hemagglutinin and thus fail to facilitate virus release

26
Q

MOA for zanamivir

A

Zanamivir works by binding to the active site of the neuraminidase protein, rendering the influenza virus unable to escape its host cell and infect others

27
Q

MOA for amantidine

A

inhibits entry/uncoating–> involves interference with the viral protein, M2, a proton channel

28
Q

will amantidine work on influenza B

A

no because the M protein channel has a deifferent configuraiton..amantidine has no specificity for this

29
Q

Rimantidine MOA

A

M2 proton channel inhibitor

30
Q

tx of adeno virus

31
Q

prevention of adenovirus

A

vaccine for type 4 and 7

32
Q

MOA for valacyclovir and acyclovir

A

becomes GTP, incorporates into DNA polymerase–> chain termination
VALACYLOVIR=prodrug for acyclovir

33
Q

MOA or ribavirin

A

“inhibits viral nucleic acid synthesis”
DNA viruses–> ihibit IMP-dehydrogenase…cell runs out of GMP/GTP
RNA–> incorporates into chain…terminations

34
Q

MOA for cidofovir

A

inhibits viral DNA polymerase

35
Q

review metabolism of antivirals

36
Q

contraindicated in narrow angle glaucoma and breast feeding

A

amantadine

37
Q

black box warning for renal impairment/toxicity

38
Q

adverse neuropysche effects

A

oseltamvir

*ALSO SERIOUS SKIN EFFECTS REPORTED

39
Q

blck box warning for hemolytic anemia and M/F teratogenicity

40
Q

minimal adverse effects

A

rimantidine, oseltamvir

41
Q

acyclovir/ valacyclovir side effects

A

elevate hepatic enzymes, use caution with other reno-toxic drugs, maintain hydration, rhinnitis, nasopharyngitis,

42
Q

side effects of zanamivir

A

FATAL broncho spasm–> NOT TO BE USED WITH UNDERLYING PULMONARY DISEASE

throat/tonsil pain,

43
Q

metabolism of acyclovir

A

viral cells metab. to triphosphate form

–> syst. elim unchanged by gfilt and sec.

44
Q

metabolism of amantadine

A

–> syst. elim unchanged by gfilt and sec.

45
Q

metabolism of cidofovir

A

metabolized by pyrimidine nucleoside monophosphate kinase to mono–> dipho analogs, then to the monophosphate-choline
–>–> syst. elim unchanged by gfilt and sec.

46
Q

Metabolism of oseltamvir

A

hepatically metab to the carboxyllate form

–> syst. elim unchanged by gfilt and sec.

47
Q

metabiolism of ribavirin

A

non-cyp mediated metabolism in Multi-N-Giant cells with systemic elimination in the urine

48
Q

metablism of ramantidine

A

extensively first pass metabolized by cyps in liver

–> renal elimination

49
Q

metabolism of valacyclovir

A

first pass metab to acyclovir,

–> syst. elim as acyclovir, unchanged by gfilt and sec.

50
Q

metabolism of zanamivir

A

renally eliminated unchanged

Pulmonology (10 decks)

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