Treatment of Viral Infections - Ch. 97 & 98 Flashcards
What are viruses?
Tiny microorganisms that infect and replicate insiede host cells
What is SARS CoV -2?
Virus = Severe acute respirotory syndrome coronavirus 2
Disease is called Coronavirus disease (COVID-19)
What are some problems associated with viral treatments?
Viruses are difficult to kill because they live inside host cells
- any drug that kills a virus may also kill cells
Viral infections are often initially asymptomatic
- delay of treatment until infection is well established (extensive replication)
What is the best response to viral infections?
Competent immune system
-Good immune system with eliminate/destroy virus replication
A healthy immune system works _______________ with the drug to eliminate or suppress viral activity
Synergistically
Who has frequent viral infections?
Immunocomprimised patients
-Cancer pt. leukemia, lymphoma
-Transplant pt. (immunosuppressants)!!!
-AIDS (attacks immune system)
How do most antiviral drugs work?
Inhibit replication of the virus inside the host cell
-Doesnβt directly destroy mature virions
What viruses are controlled by current antiviral therapy?
Cytomegalovirus (CMV)
Hepatitis virus
Herpes virus
Human immunodeficiency virus (HIV)
Influenza virus (Flu)
Respiratory syncytial virus (RSV)
What are the 2 families of antiviral medications?
Antiretroviral drugs
Antiviral drugs
What are antiretrovirals used to treat?
infections caused by HIV, the virus that causes AIDS
What are antivirals used to treat?
Infections caused by viruses
HIV is a member of which family?
Retroviruses
-Host cells turn DNA into RNA
retroviruses reverse it
HIV is a virus that leads to what syndrome?
Aquired immunodeficiency syndrome (AIDS)
How is HIV transmitted?
Sexual activity
Intravenous drug use
Mother to fetus
Whata re the 5 oppurtunist infections seen in HIV-infected patients?
Protozoal
Fungal
Viral
Bacterial
Oppurtunistic neoplasias
What are protozoal opportunistic infections?
Toxoplasmosis of the brain, others
What are fungal opportunistic infections?
Candidiasis of lungs, esophagus, trachea
Pneumocystis jirovecii pneuomonia, others
What are viral opportunistic infections?
CMV, HSV, others
What are bacterial opportunistic infections?
Various mycobacterial infections, others
Extra pulmonary tuberculosis (TB)
What are Opportunistic neoplasias?
Kaposiβs sarcoma, others
What are the 3 focused groups of antivirals for HIV (antiretrovirals)?
Reverse transcriptase inhibitors
Protease Inhibitors
Integrase inhibitors
How do Reverse transcriptase inhibitors (RTIs) work?
Block activity of the enzyme reverse transcriptase and prevents production of new DNA from viral RNA
Whata re the subclasses of RTIs?
Nucleoside RTIs (NRTIs)
Non-nuceloside RTIs (NNRTIs)
What do NRTIs do?
Competes with cell nucelosides for DNA syntehsis
Example of NRTI?
Zidovudine (AZT: Azidothymidine)
What is the major adverse effect associated with NRTIs?
Bone marrow supression
-anemia and neutropenia
How do Protease inhbitors (PIs) work?
Inhbit the retroviral protease enzyme which prevents viral protein preparation
What adverse effects are associated with PIs? (protease inhibitors)
Hyperglycemia, new/exacerbate diabetes
What are some examples of protease inhibitors?
!! Ritonavir
atazanavir sulfate
fosamprenavir
indinavir
nelfinavir
Ritonavir has many what?
Drug-drug interactions
CYP450 inhibitor and inducer