Unit 3: K49.Antivirals Flashcards
Most used antiherpes drug
Acyclovir
Acyclovir has a ____half life
Short —> must be dosed frequently
How is valacyclovir related to acyclovir?
Adjusted medication to extend half life; can be taken less frequently
Brand name for docosanol; what is it used to treat?
Abreva; cold sores
What is CMV?
Cytomegalovirus; it is a mono-like illness
What can be used to treat CMV?
Ganciclovir
5 Anti-HIV Classes
- NRTIs = nucleoside reverse transcriptase inhibitors
- NNRTIs = nonnucleoside reverse transcriptase inhibitors
- Protease inhibitors
- Entry and Fusion Inhibitors
- Integrase Strand Transfer Inhibitors (INSTs)
Viruses have RNA or DNA?
RNA
MOA:
NRTIs = nucleoside reverse transcriptase inhibitors
NNRTIs = nonnucleoside reverse transcriptase inhibitors
Block reverse transcription of viral RNA into DNA
MOA: Protease inhibitors
Block viron assembly and virus from leaving cell (stop virus from finishing maturation process)
MOA: Entry and Fusion Inhibitors
Block entry of virus into cell or fusion with cell
MOA: Integrase Strand Transfer Inhibitors (INSTs)
Block integration of viral DNA with host DNA nucleus; block hijacking of nucleus
HAART stands for…
Highly active antiretroviral therapy
*** must use multiple medications for HIV
Why can’t we get rid of HIV?
Virus is very successful at hiding out in some of our cells
What is genotype testing for a virus?
Basically a Culture and Sensitivity for a virus
Adverse effects: NRTIs
Symptoms?
Can cause lactic acidosis
Sx: muscle aches or changes in liver enzymes
Check: liver functions, lactic acid levels
NNRTI Sustiva (efavirenz) can cause what?
Bizarre dreams
Adverse effects: NNRTIs
Rash
Raise cholesterol
NNRTI Nevirapine can cause what?
Stevens Johnson Syndrome
Adverse effects: protease inhibitors
Strange fat distribution: Buffalo hump, gynecomastia, truncal obesity
Facial and peripheral lipodystrophy (fat wasting/gaunt looking)
Adverse effects of Maraviroc (entry and fusion inhibitor)
Cough, diarrhea, muscle and joint pain, increases in hepatic transaminases
Two once daily pill recommendations for new HIV treatment
Biktarvy (Bictegravir/TenofovirAF/Emtrictabine)
Triumeq (Abacavir/Lamivudine/Dolutegra)
Two categories of people at highest risk for HIV
MSM (men who have sex with men)
PWID (people who inject drugs)
What is PrEP?
Medication regimen for those who are at high risk of contracting HIV
Two meds on the PrEP regimen
Truvada
Descovy
What is required for patients on PrEP?
See every three months
Screen for HIV (stop PrEP, start HAART of positive)
Check BMP (kidney function)
Chronic hepatitis B typically comes from …
Asia, transmitted from mother to child
Acute hepatitis B typically comes from…
Sexual transmission
OR blood/body fluids
Why is hepatitis B uncommon in the US?
We vaccinate against it
Two classes of anti-influenza agents
Neuraminidase inhibitors
Adamantanes
Why are adamantanes no longer used for flu?
High level of resistance
Only effective against flu A
Why does Tamiflu (oseltamivir) work best if initiated within 24-48h of flu onset?
It interferes with viral replication
What is the benefit of Tamiflu? What is the cost?
Can decrease duration of flu by half a day or so.
Out of pocket cost ~ $100
What is Synagis (palivizumab) used for? How is it dosed?
Young children to help prevent/fight RSV
Once monthly IM injections (15mg/kg) for 5 months during RSV season
Palivizumab is a -mab, so to what class does it belong?
Monoclonal antibodies
What is Aldara (imiquimod cream) used for?
Treatment of genital and perinatal warts, as well as plantars warts
List NRTIs [8]
Abacavir Didanosine Emtricitabine Lamivudine (3TC) Stavudine (d4T) Tenofovir Zalcitabine (ddC) Zidovudine
List NNRTIs [5]
Delavirdine Efavirenz Etravirine Nevirapine Rilpivirine
List Protease Inhibitors [9]
Atazanavir Darunavir Fosamprenavir Indinavir Lopinavir/ritonavir Nelfinavir Ritonavir Saquinavir Tipranavir
List Entry and Fusion Inhibitors [2]
Maraviroc
Enfuvirtide
List Integrase Strand Transfer Inhibitors (INSTs) [3]
Raltegravir
Dolutegravir
Elvitegravir
3 neuraminidase inhibitors
oral oseltamivir
inhaled zanamivir
IV peramivir
2 adamantanes
amantadine
rimantadine
