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STEP 1 (4) > Viral Pharmacology > Flashcards

Viral Pharmacology Flashcards

1
Q

Ho do Oseltamivir and Zanamivir work?

A

They inhbiit influenza neuraminidiase to prevent release of progenzy in the tx and prevention of influenza A and B

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2
Q

What are acyclovir, famciclovir, and valacyclovir?

A

These are GUANOSINE analogs which are monophosphorylated by HSV/VZV thymidine kinase and not phosphorylated in uninfected cells (few AEs). Triphosphohate foremed by cellular enzymes

Preferentially inhibit viral DNA polymerase by chain termination

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3
Q

Uses of acyclovir, famciclovir, and valacyclovir (better bioavailability)?

A

HSV and VZV and some weak activity against EBV. No activity against CMV. Used for HSV- induced mucocutanoeus and genital lesions as well as for encephalitis.

Prophylaxis in immunocompromised pts.

No effects on the latent forms of HSV and VZV.

For herpes zoster, used famiclovir

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4
Q

AEs of acyclovir, famciclovir, and valacyclovir?

A

Obstructive cystralline nephropathy and acute renal failure if not hydrated well

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5
Q

How does ganciclovir work?

A

5’-monophosphate formed by a CMV viral kinase (resistance: muatted viral kinase). Guanosine analog. Triphosphate formed by cellular kinases. Preferentially inhibits viral DNA polymerase by chain termination

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6
Q

Uses of ganciclovir?

A

CMV, esp. in immunocompromised. Valganciclovir has better bioavailability

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7
Q

AEs of ganciclovir?

A

pancytopenia, renal toxicity

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8
Q

How does Foscarnet work?

A

Viral DNA/RNA polymerase inhbiitor and HIV reverse transcriptase inhibitor. Bnds to pyrophosphate-binding site of enzyme. Does NOT require virl kinase activation (resistance: mutated DNA polymerase)

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9
Q

Uses of Foscarnet?

A

CMV retinitis when ganciclovir failures, acyclovir-resistant HSV

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10
Q

AEs of Foscarnet?

A

nephrototocitiy, electrolyte abnormalities can lead to seizures

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11
Q

How does Cidofovir work?

A

Inhibits viral DNA polymerase. Does NOT require phosphorylation by viral kinase

Used in tx of CMV retinitis (long half-life)

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12
Q

Note on HIV therapy

A

HAART therapy initiated at the time of HIV diagnosis. Strongest indication for pts presenting ith AIDs-defining illnes, low CD4 counts, or high viral load.

Regimen needs to consst of 3+ drugs to prevent resistance: 2 NRTIs and 1 of: NNRTI, protease inhbiitor, or integrase inhbitior

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13
Q

What are the HIV protease inhibitors?

A

-NAVIRs (e.g. atazanavir, darunavir, idinavir, ritonavir, lopinavir)

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14
Q

How do HIV protease inhibitors work?

A

Assembly of virions depends of HIV-1 protease (pol gene) which cleaves the polypeptide prodcuts of HIV mRNA into functional parts.

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15
Q

What are the NRTIs?

A

Abacavir

Didanosine

Emtricitabine

Lamivudine

Stavudine

Tenofovir

Zidovudine

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16
Q

How do the NRTIs work?

A

Competitively inhbiit nucleoide abinding to reverse transcriptase and terminate the DNA chains (lack a 3’OH group). tenofovir is a nucleotide and the others are nucleosides and need to be phosphorylated to be active

17
Q

What is the prophylaxis for HIV and the drug used to decrease fetal transmission risk?

A

Zidovudine

18
Q

What are the NNRTIs?

A

Delaviridne, Efavirenza, Nevirapine (bind to reverse transcriptase at sites different from NRTIs and do NOT require phosphorylation to be active)

19
Q

AEs of NNRTIs?

A

Rash and hepatotoxicity are common to all

vivid dreams and CNS symtposm with Efavirenza

Delaviridine and Efavirenza contraindicated in pregnancy

20
Q

What is Raltegravir?

A

Integrase inhbiitor, which inhbiits HIV genome integration into host cell chromosomes (elevated creatine as an AE)

21
Q

What are the HIV fusion inhbitiors?

A

Enfuvirtide- Binds gp41, inhibiting viral entry

Maraviroc- Binds CCr-5 on surface of T cells/monocytes, inhibiting interaction with gp120

22
Q

What are Interferons?

A

Glycoproteins norally synthesized by virus-infected cells, exhibiting antiviral and antitumoral properties

23
Q

What are the clinical uses of IFN-a?

A

chronic HBV and HCV, Kaposi sarcoma, hairy cell leukemia, condyloma acuminatum, renal cell carcinoma, malignant melanoma

24
Q

What are the clinical uses of IFN-B?

A

MS

25
Q

What are the clinical uses of IFN-y?

A

CGD

26
Q

What are the mainstays of HCV therapy?

A
  1. Ribavirin- inhbiits synthesis of guanine nucleotides by inhibiting inosine monophosphate dehydrogenase
  2. Simeprevir- HCV proetase inhibitor; prevents viral replication (dont use as monotherapy)
  3. Sofosbuvir- Inhibits HCV RNA-dependent RNA polymerase acting as a chain terminator (Dont use as monotherapy)
27
Q

Infection control techniques:

Autoclave- pressurized steam at 120C. May be sporicidal

Alcohols and Chlorhexidine- denature proteins and disrupts cell membranes and not sporicidal

A

Hydorgen Peroxide- Free Radical Oxidation. Sporicidal

Iodine- halogenation of DNA, RNA, proteins. May be sporicidal

STEP 1 (4) (18 decks)

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