Treatment Of Viral Infections (97, 98) Flashcards by Ella Thorsteinson

What are viruses

Tiny microorganisms that infect and replicate inside host cells

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How do viruses replicate and survive

Cannot replicate on its own, and use cell machinery to synthesize protein, DNA and RNA

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Virus =

Severe active respiratory syndrome coronavirus 2
(SARSC2)

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Disease =

Coronavirus disease 2019
(COVID19)

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Problems with viral treatments

Viruses are difficult to kill because they live inside host cells
-any drug that kills a virus may also kill cells

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Viral infections are often initially

asymptomatic
-delay of treatment until infection is well established

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A competent immune system has the ability to

-respond best to viral infections
-eliminates or effectively destroy virus replication
-work synergistically with the drug

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Who is at risk to frequent viral infections

Immunocompromised

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Examples of patients who are susceptible to viral infections

-cancer patients, leukaemia or lymphoma
-immunosuppressants
-AIDS

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How do most antiviral drugs work

Inhibiting replication of virus inside host cell
-don’t directly destroy mature visions

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What kind of viruses are currently able to be controlled by antiviral therapy

-cytomegalovirus
-hepatitis viruses
-herpes viruses
-human immunodeficiency virus
-influenza viruses
-respiratory syncytial virus

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Antiretroviral drugs are used to treat

Infections caused by HIV
-the virus at causes AIDS

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Antiviral drugs are used to treat

Infections caused by viruses
-generally every other virus other than HIV

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Host cells produce ___ into ___

DNA into RNA

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Retroviral cells produce __ into ___

RNA into DNA

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HIV

Leads to AIDS
-retrovirus family
-sexually, IV drug use, mother to fetus

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Protozoal opportunistic infections in HIV patients

Toxoplasmosis of the brain + others

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Fungal opportunistic infections in HIV patients

-candidiasis of the lungs, esophagus, trachea
-pneumocystis jiroveci pneumonia, others

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Viral opportunistic infections in HIV patients

CMV, HSV, others

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Bacterial opportunistic infections in HIV patients

Various mycobacterial infections, extrapulmonary TB

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opportunistic neoplasias infections in HIV patients

Kaposi’s sarcoma

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There are four groups of antiretrovirals, what are the three we are focusing on

-reverse transcriptase inhibitors
-protease inhibitors
-integrase inhibitors

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Antivirals for HIV

Reverse transcriptase inhibitors

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Reverse transcriptase inhibitors

Block activity of the enzyme reverse transcriptase
-prevents production of new DNA from viral RNA

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Subclasses of Reverse transcriptase inhibitors

Nucleosides RTIs and non-nucleoside RTIs

Nucleoside RTIs

Competes with cell nucleosides for DNA synthesis -look similar to nucleoside bases and are able to join in the construction halting the furthering of DNA

Zidovudine

Nucleoside RTIs -reverse transcriptase inhibitor -for HIV -milestone drug

Adverse effects of Nucleoside RTIs

Bone marrow suppression, anemia and neutropenia

Protease inhibitors

Inhibit the retroviral protease enzyme which prevents viral protein preparation Protease is needed to chop up amino acid chains to make into proteins, inhibiting this stops protein prep

A viral enzyme means a good..

Drug target

Protease inhibitors adverse effects

Hyperglycemia to the point of new/exacerbate diabetes

Ritonavir

Protease inhibitor -many drug to drug interactions -CYP450 inhibitor and inducer (can make it tricky with multiple drugs)

HIV integrase strand transfer inhibitors (INSTI)

Inhibit insertion of HIV DNA into CD4 (T helper) cell DNA -by inhibiting integrase (enzyme)

Combination therapy is essential for

HIV treatment -antiviral resistance is increasing bc HIV has so many random mutations

HAART or Highly active antiretroviral therapy

-goal is to reduce HIV in plasma - viral load =no aids development =cannot pass virus to others

Drug combinations

-2 NRTIs + 1 NNRTI -2 NRTIs + 1/2 protease inhibitors -BIKTARVY

BIKTARVY

Single tab treatment of HIV 1 infection (inc drug adherence) -integrase inhibitor + 2 NRTIs

PrEP or pre exposure prophylaxis

Take daily if at risk for contracting Example- if ur partner has HIV -Tenofovir and emtricitabine -2 RTI combination

To prevent acquisition of HIV infection by uninflected persons..

Daily drug regime of PrEP

PEP or post exposure prophylaxis

Drugs taken very soon after possible exposure to HIV -start within 3 days lasts 28

Example of a PEP

Raltegravir + tenofovir + emtricitabine

Most common form of influenza virus

A ~96%

Most common hepatitis

B and C -also the only chronic conditions

Influenza virus A surface proteins

H and N -H1N1 and H3N2

Non nucleoside RTIs

Do not reseamble a nucelotide and rather stop the enzyme from working than join the DNA synthesis

Non nucleoside RTIs

Do not reseamble a nucelotide and rather stop the enzyme from working than join the DNA synthesis

Three viruses apart of the herpesvirus group

-varicella zoster virus -herpes simplex virus -cytomegalovirus

Varicella zoster virus includes

-chickenpox (varicella) -shingles (herpes zoster)

Herpes simplex viruses includes

-HSV 1 (oral herpes) -HSV 2 (genital herpes)

Neuraminidase inhibtors

Prevent release of virus from host cell -treat influenza virus -treatment begins within 2 days of symptoms

Example of neuraminidase inhibtiors

Oseltamivir

Neuraminidase inhibitor -active against influenza A and B virus -adverse effects= nausea and vomiting

Neuraminidase inhibtors can be used

Prophylactically when vaccination is not possible or in early stages of infection -usually stock piled to use in swine flu

Neuraminidase inhibtiors can reduce recovery time when used

Therapeutically

Baloxavir (DO NOT STUDY)

Newer flu drug -single dose regime -equal effectiveness to oseltamivir

DNA polymerase inhibtors

Synthetic nucleoside analogues -stops viral DNA synthesis

Example of DNA polymerase inhibtiors

Acyclovir

Used to suppress replication of herpes virus -good for initial and recurrent episodes -oral, topical, parenteral forms

Cytomegalovirus

Member of herpesvirus family -asymptomatic (risky in immunocompromised patients) -spread by bodily fluids

Ganciclovir

DNA polymerase inhibitor -synthetic nucleoside analogue

Ganciclovir

DNA polymerase inhibitor -synthetic nucleoside analogue

Ganciclovir is used to treat

-Cytomegalovirus (which affects brain, eye, lung, GI) -CMV retinitis (ophthalmic eyes)

Ganciclovir is available in

Oral and parenteral forms

Ribavirin

Synthetic nucleoside -mechanisms are unclear

Ribavirin is used to treat

-respiratory syncytial virus -hep C

Ribavirin is taken

Via nasal inhalation -hospitalized infants with RSV

Treatment Of Viral Infections (97, 98) Flashcards

(66 cards)