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HLSC 220 Pharmacotherapeutics for Health Professionals 💊 > Treatment of Viral Infections - Ch. 97 & 98 > Flashcards

Treatment of Viral Infections - Ch. 97 & 98 Flashcards

1
Q

What are viruses?

A

Tiny microorganisms that infect and replicate insiede host cells

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2
Q

What is SARS CoV -2?

A

Virus = Severe acute respirotory syndrome coronavirus 2

Disease is called Coronavirus disease (COVID-19)

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3
Q

What are some problems associated with viral treatments?

A

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)

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4
Q

What is the best response to viral infections?

A

Competent immune system
-Good immune system with eliminate/destroy virus replication

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5
Q

A healthy immune system works _______________ with the drug to eliminate or suppress viral activity

A

Synergistically

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6
Q

Who has frequent viral infections?

A

Immunocomprimised patients
-Cancer pt. leukemia, lymphoma
-Transplant pt. (immunosuppressants)!!!
-AIDS (attacks immune system)

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7
Q

How do most antiviral drugs work?

A

Inhibit replication of the virus inside the host cell
-Doesn’t directly destroy mature virions

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8
Q

What viruses are controlled by current antiviral therapy?

A

Cytomegalovirus (CMV)
Hepatitis virus
Herpes virus
Human immunodeficiency virus (HIV)
Influenza virus (Flu)
Respiratory syncytial virus (RSV)

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9
Q

What are the 2 families of antiviral medications?

A

Antiretroviral drugs
Antiviral drugs

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10
Q

What are antiretrovirals used to treat?

A

infections caused by HIV, the virus that causes AIDS

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11
Q

What are antivirals used to treat?

A

Infections caused by viruses

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12
Q

HIV is a member of which family?

A

Retroviruses
-Host cells turn DNA into RNA
retroviruses reverse it

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13
Q

HIV is a virus that leads to what syndrome?

A

Aquired immunodeficiency syndrome (AIDS)

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14
Q

How is HIV transmitted?

A

Sexual activity
Intravenous drug use
Mother to fetus

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15
Q

Whata re the 5 oppurtunist infections seen in HIV-infected patients?

A

Protozoal
Fungal
Viral
Bacterial
Oppurtunistic neoplasias

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16
Q

What are protozoal opportunistic infections?

A

Toxoplasmosis of the brain, others

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17
Q

What are fungal opportunistic infections?

A

Candidiasis of lungs, esophagus, trachea
Pneumocystis jirovecii pneuomonia, others

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18
Q

What are viral opportunistic infections?

A

CMV, HSV, others

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19
Q

What are bacterial opportunistic infections?

A

Various mycobacterial infections, others
Extra pulmonary tuberculosis (TB)

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20
Q

What are Opportunistic neoplasias?

A

Kaposi’s sarcoma, others

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21
Q

What are the 3 focused groups of antivirals for HIV (antiretrovirals)?

A

Reverse transcriptase inhibitors
Protease Inhibitors
Integrase inhibitors

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22
Q

How do Reverse transcriptase inhibitors (RTIs) work?

A

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

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23
Q

Whata re the subclasses of RTIs?

A

Nucleoside RTIs (NRTIs)
Non-nuceloside RTIs (NNRTIs)

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24
Q

What do NRTIs do?

A

Competes with cell nucelosides for DNA syntehsis

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25
Q

Example of NRTI?

A

Zidovudine (AZT: Azidothymidine)

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26
Q

What is the major adverse effect associated with NRTIs?

A

Bone marrow supression
-anemia and neutropenia

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27
Q

How do Protease inhbitors (PIs) work?

A

Inhbit the retroviral protease enzyme which prevents viral protein preparation

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28
Q

What adverse effects are associated with PIs? (protease inhibitors)

A

Hyperglycemia, new/exacerbate diabetes

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29
Q

What are some examples of protease inhibitors?

A

!! Ritonavir
atazanavir sulfate
fosamprenavir
indinavir
nelfinavir

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30
Q

Ritonavir has many what?

A

Drug-drug interactions
CYP450 inhibitor and inducer

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31
Q

What is the full name for integrase inhibitors?

A

HIV integrase strand transfer inhibitors (INSTIs)

32
Q

How do INSTIs work?

A

Inhbits insertion of HIV DNA into CD4 (T-helper) cell DNA

33
Q

Examples of INSTIs?

A

Raltegravir
Dolutegravir
Bictegravir
Elvitegravir

34
Q

What is essential for HIV treatment?

A

Combination therapy

35
Q

What is the name of anti-viral therapy used to treat HIV?

A

Highly active antiretroviral therapy (HAART)

36
Q

What is the goal of HAART?

A

Reduce HIV in plasma - viral load
= no AIDS development
= cannot pass virus to other people

37
Q

What are some HIV anti-viral drug combos?

A

2 NRTIs + 1 NNRTI
2 NRTIs + 1 or 2 Protease inhibitors

BIKTARVY bictegravir/emtricitabine/tenofovir
alafenamide

38
Q

What is BIKTARVY?

A

Single tab treatment of HIV-1 infection (Aug 2018)
Intergrase inhibitor + 2 NRTIs

39
Q

What is taken to prevent acquisition of HIV infection by uninfected persons?

A

Pre-exposure Prophylaxis (PrEP) as a daily drug regime

40
Q

What is Pre-exposure Prophylaxis (PrEP)?

A

Tenofovir and emtricitabine
2 rti combination

41
Q

What is taken very soon after possible exposure to HIV?

A

Post-exposure Prophylaxis (PEP)

42
Q

When can you start PEP?

A

Within 3 days
-Lasts 28 days

43
Q

Example of PEP drugs?

A

Raltegravir + tenofovir + emtricitabine

44
Q

What are the types of influenza virus?

A

A (~96%)
B
C

45
Q

Which influenza virus has less severe symptoms?

A

Influenza C

46
Q

What does influenza A have on the surface of its virus?

A

H and N surface proteins
e.g, H1N1, H3N2

47
Q

What are the different kinds of Hepatitis viruses?

A

A, B, C, D, E, G

48
Q

What viruses belong to the Herpesvirus group?

A

Varicella zoster virus
Herpes simplex viruses
Cytomegalovirus

49
Q

What viruses are part of Varicella zoster?

A

Varicella = Chickenpox
Herpes Zoster = Shingles

50
Q

What are the first two kinds of herpes?

A

HSV-1 = oral herpes
HSV-2 = genital herpes

51
Q

What antivirals are used for influenza?

A

Neuraminidase inhibitors

52
Q

How do neuraminidase inhibitors work?

A

Prevents realse of virus from host cell

53
Q

Examples of neuraminidase inhbitor drugs?

A

Oseltamivir (Tamiflu)
zanamivir

54
Q

Oseltamivir (Tamiflu) is active against which types of influenza?

A

influenza A and B virus

55
Q

What adverse effects are associated with Oseltamivir (Tamiflu)?

A

GI disturbances
-nausea, vomiting, diarrhea

56
Q

Treatment of influenza should being within what?

A

2 days of influenza symptom onset

57
Q

When can neuraminidase inhibitors be used prophylactically?

A

When vaccination is not possible or in early stages of infection

58
Q

Neuraminidase inhibitors were stock piled to use during what?

A

Swine (H1N1) flu

59
Q

Neuraminidase inhibitors can reduce what when used therapeutically?

A

Recovery time

60
Q

What is a newer flu drug?

A

Baloxavir
-Single dose regime

61
Q

Baloxavir has equal effectiveness to which drug?

A

Oseltamivir

62
Q

What drugs are used for Herpes virus (VZV and HSV)?

A

DNA polymerase inhibitors

63
Q

How do DNA polymerase inhibitors work?

A

Act as synthetic nucleoside analogues which stops viral DNA syntehsis

64
Q

Example of DNA polymerase inhbitor drug used to treat herpes virus?

A

Acyclovir (Zovirax)

65
Q

What is Acyclovir used for?

A

Suppress replication of Herpes (HSV-1, HSV-2, VZV)
-For treatment of initial and recurrent episodes of these infections

66
Q

What are the available forms of acyclovir?

A

Oral
Topical
Parenteral

67
Q

What is Cytomegalovirus (CMV)?

A

Member of herpes virus family
Many have the virus but don’t show symptoms

68
Q

How is cytomegalovirus spread?

A

Bodily fluids
-high risk in immunocomprimised patients

69
Q

What drugs are used for cytomegalovirus (CMV)?

A

DNA Polymerase inhibitors

70
Q

Exampels of DNA polymerase inhibitors used to treat CMV?

A

Ganciclovir

71
Q

What can ganciclovir affect?

A

Brain, eye, lung and GI tract

72
Q

Ganciclover is used to treat CMV ________?

A

CMV retinitis
-Ophthalmic form surgically implanted

73
Q

What are the available forms of Ganciclovir?

A

Oral
Parenteral

74
Q

What antiviral DNA polymerase inhibitor is used to treat respiratory syncytial virus (RSV) and hepatitis C?

A

Ribavirin (mechanism unclear)

75
Q

How is Ribavirin administered?

A

PO or nasal inhalation

76
Q

Which patients is Ribavirin nasal inhalation used?

A

Hospitalized infants with RSV

HLSC 220 Pharmacotherapeutics for Health Professionals 💊 (31 decks)

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