T2 - L2 ANTIVIRALS Flashcards
what 3 things does a virus consist of?
Nucleic acid (DNA or RNA)
Protein (coat - structural, enzymes-non-structural)
+/- Lipid envelope
Obligate intracellular parasites
list acute (RNA viruses)
Influenza, measles,
mumps, hepatitis A virus
list Chronic, latent viruses (generally DNA viruses)
Herpes simplex, Cytomegalovirus
when should you use antivirals for acute infections?
people with high risk e.g. elderly
when should you use antivirals>
- acute infections in vulnerable/high risk patients
- chronic infections
- infections in immunocompromised
besides an infection, when else may a patient receive antivirals?
if they’re immocompromised:
- post transplant
- patients receiving immunosuppressive therapies
- patients with primary immunodeficiencies.
what antiviral would you give to treat HSV? (herpes simplex virus)
aciclovir
incl:
- encephalitis
- disseminated HSV
- Primary oral-labial or genital herpes
- chicken pox (adults) and shingles
what antiviral do we treat chicken pox in adults with? Why don’t we treat children with it?
aciclovir
- adult = inc age = inc morality chance
- treat within first 48 hours or aciclovir doesn’t have an affect
- children tend to recover other own
why don’t we treat immunocompetent people with antivirals?
won’t work as their immune response would’ve already started
what antiviral would you give to treat influenza?
Neuraminidase inhibitors: oseltamivir (oral) and zanamavir (inhaled)
when should you treat influenza with an antiviral?
high risk patients only
- chronic disease
- diabetes mellitus
- immunosuppressed
- over 65 years
- pregnant
- under six months of age
- morbidly obese
what can chronic hepatitis C (HCV) lead to?
cirrhosis/liver damage
what are the 8 steps in virus replication?
- Virus attachment to cell (via receptor)
- Cell Entry
- Virus Uncoating
- Early proteins produced – viral enzymes
- Replication
- Late transcription/translation – viral structural proteins
- Virus assembly
- Virus release and maturation
what do antivirals target?
the unique proteins which are produced by the virus - which are vital for virus replication
which drug inhibits HIV replication?
AZT (azidothymidine)
- not used anymore as it is toxic and can cause long term problems e.g. changes in fat deposition, mitochondrial toxicity
what type of drug is AZT (azidothymidine)?
Nucleoside Reverse Transcriptase Inhibitor (NRTI)
what are the three NRTI drugs now used for the treatment of HIV?
HIV NRTIs:
Lamivudine (cytosine analogue)
Abacavir Tenofovir (purine analogues)
what drug do you use to treat the hep B virus (HBV)?
Lamividine
Tenofovir
Aciclovir
Ganciclovir
what drug do you use to treat the hep C virus (HCV)?
Sofosbuvir
how do you know if the drug is a Nucleoside Reverse Transcriptase Inhibitors (NRTI)?
- inhibits reverse transcriptase
- all end in vir except Lamivudine
how do you know if the drug is Non-Nucleotide Reverse Transcriptase inhibitors (NNRTIs)?
- “vir” in the middle of the drug name
what are proteases?
enzymes that break proteins at particular sequences to make shorter molecules
which protease inhibitors are used to treat HIV?
Atazanavir Darunavir Ritonavir*
which protease inhibitors are used to treat HCV?
Paritaprevir Grazoprevir
