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Drug final > COVID-19 Vaccines and Drugs > Flashcards

COVID-19 Vaccines and Drugs Flashcards

1
Q

What is the structure of SARS-CoV-2?

A
  • virus that causes covid 19
  • has spike proteins that protrude out of their shell, which bind to receptors or proteins on cells
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2
Q

Which human receptor does the spike protein bind to?

A

ACE2 receptor

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3
Q

What happens once SARS-CoV-2 is inside the cell?

A
  • the virus releases its genetic material (viral RNA)
  • infected human cells read the genetic material and begin to make part of the virus
  • new copies of the virus are assembled and carried to the outside of the cell (infecting other nearby cells)
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4
Q

What is the coronavirus?

A

a large family of viruses that can infect humans or animals
- causes ilnesses that range from the common cold to the 2003 SARS and 2012 MERS outbreaks

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5
Q

What does R0 tell us?

A

how contagious a disease is (average # of individuals that get infected from one infectious person)
- COVID-19: 2-2.5
- SARS: 2-4
- MERS: 2.5-7.2
(we want R0<1)

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6
Q

How is the COVID-19 fatality rate compared to other diseases?

A

it has a lower fatality rate than its related

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7
Q

What were some platforms used to develop COVID-19 vaccines?

A
  • viral vectors
  • genetic vaccines deliver the pathogen’s gene into host cells
  • the pathogen’s DNA is attached to a nanoparticle
  • a pathogen’s whole protein/protein fragments are used to make the vaccine
  • killed/inactivated virus vaccines
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8
Q

What are some approaches to trigger an immune response?

A
  • using a whole virus or bacterium
  • parts that trigger the immune system (surface)
  • just the genetic material
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9
Q

What are viral vectors?

A
  • modified viruses that deliver genetic code for antigen
  • vectors do not contain disease-causing genes
  • broken down into replication or non-replicating
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10
Q

How can DNA/RNA be used for vaccines?

A

DNA or RNA that codes for antigen protein
- can be encapsulated in a fatty coat to fuse with the cell membrane and deliver the genetic material inside

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11
Q

How can proteins be used for vaccines?

A
  • protein is extracted from the virus, purified, and injected as a vaccine
  • mimic the coronavirus to trigger an immune response
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12
Q

How can killed or weakened viruses be used for vaccines?

A

killed virus: virus is inactive using chemicals or heat

weakened virus: virus mutations in its genome, so it doesn’t express it viral proteins

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13
Q

Why was there no treatment found for SARS given that another viral disease is likely to reoccur?

A
  • After the SARS outbreak, vaccines against SARS-CoV were developed
  • development was halted as the virus was eradicated
  • no commercial reason to revive development at the times
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14
Q

Why was the process for COVID-19 vaccines accelerated?

A
  • they have pre-existing data from design and exploratory preclinical studies from SARS-CoV and MERS-CoV
  • Partially pre-existing and parallel development of process development preclinical, toxicology studies
  • didn’t wait for phase 1 trials to be over before starting phase 2
  • only took 10 months to 1.5 years
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15
Q

What are Comirnaty vaccines?

A

Pfizer
- mRNA that encodes the spike protein enclosed in a lipid nanoparticle (person converts mRNA to protein and mounts immune response)
- two doses administered intramuscularly 3 weeks apart

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16
Q

How were phase 1 clinical trials for the Comirnaty vaccine done?

A
  • placebo-controlled, observer-blind, dose-escalation (n=195)
  • evaluated the safety of different vaccine doses of 2 vaccine candidates
17
Q

How were phase 2/3 clinical trials for the Comirnaty vaccine done?

A

-360 adults
- evaluated the efficacy of 30 micrograms dose against placebo (narrowed down to one vaccine and 1 dose)
- data pooled with phase 3 trial

18
Q

How were phase 3 clinical trials for the Comirnaty vaccine done?

A
  • about 44,000 adolescents and adults
  • evaluated the efficacy of 30 microgram against placebo
  • vaccine was 95% effective in preventing COVID
19
Q

What are Spikevax vaccines?

A

Moderna
- mRNA that encodes the spike protein enclosed in a lipid nanoparticle
- two doses administered 4 weeks apart

20
Q

How were phase 1 Spikevax vaccine clinical trials done?

A
  • 120 healthy adults
  • evaluated the safety of 25-250 microgram vaccine doses
  • the vaccine was generally safe and well-tolerated
21
Q

How were phase 2 Spikevax vaccine clinical trials done?

A
  • 600 healthy adults
    -evaluated the efficacy of 50 and 100 micrograms against placebo
22
Q

How were phase 3 Spikevax vaccine clinical trials done?

A
  • about 30,000 adults
  • evaluated the efficacy of 100 micrograms against placebo
  • 94.1% effective in preventing covid
23
Q

What are 10 reasons we got covid vaccines so quickly?

A
  1. pandemic plans were already in place
  2. china identified the novel coronavirus early on
  3. tremendous funding was provided
  4. speedy clinical trials
  5. quick commencement of vaccine trials
  6. availability of research data
  7. studies generated many volunteers
  8. rapid results from trials
  9. early vaccines worked well
  10. regulation took place while studies were continuing
24
Q

What is Medicago’s plant-based COVID-19 vaccine?

A
  • virus-like particles are made in plants, which are then harvested and purified
  • 71% efficacy against COVID 19
  • financial and production difficulties, did not bring the vaccine to market
25
Q

What is Nuvaxovid (Novovax)?

A
  • protein-based vaccine
  • given as primary or Omicrom subvariant vaccine

Contains:
- spike proteins, produced by insect cells (bio-reactors)
- immune system stimulant, derived from the soapbark tree

26
Q

What is repurposing drugs?

A
  • using existing drugs or preclinical chemical compounds for a new purpose (new target and/or new disease)
27
Q

Why is drug repurposing used?

A

a time and cost-effective strategy for treating diseases

28
Q

What is Remdesivir?

A
  • originally produced to treat Ebola virus infections
  • an antiviral agent that needs to be metabolized to become active
  • adenosine mimic
  • no significant effect on mortality, or length of hospital stay (for people with covid)
29
Q

What is Lopinavir-ritonavir?

A
  • used for the treatment and prevention of HIV/AIDS
  • protease inhibitor
  • no added benefit beyond standard care (for people with covid)
30
Q

What is Chloroquine/ Hydroxychloroquine?

A
  • anti-malarial drug
  • increases pH of lysosomes and endosomes (neutralized the virus)
  • no added benefit beyond standard care (for people with covid)
31
Q

What is Paxlovid?

A
  • each dose is 3 tablets (2 nirmatrelvir + 1 ritonavir)
  • led by rookie drug development
  • chemical similarity to peptide, blocks viral protease
32
Q

What are PK (pharmacokinetic) boosters?

A
  • a compound used in combination with primary therapeutic agents that do no directly affect the disease but rather enhance the activity of the primary agent (ritonavir: is the component of paxlovid that affects the PK of nirmatrelvir)
33
Q

What are the advantages of PK boosters?

A
  • allows for lower dosage of primary agent while having theraptic levels
  • reduces pill burden and dosing frequencey
  • reduces extent of toxic side effects due to lower dose of primary drug
34
Q

How did the phase 2/3 clinical trials for Paxlovid go?

A
  • trial stopped early because the drug was so good
  • 88-89% reduction in hospitalization/ death compared to placebo
  • 0 deaths vs 12 in placebo
35
Q

What is the efficacy of Paxlovid?

A

reduction in risk of COVID-19 related hospitalization or death from any cause in patients who took it within 5 days of symptoms

36
Q

What is long COVID?

A

symptoms of COVID persists for more than 12 weeks after the infection (over 100 symptoms recorded)

37
Q

What are some symptoms of long-term covid?

A
  • heart (chest pains)
  • lungs (cough)
  • immune system (autoimmunity)
  • pancreas (diabetes)
  • GI track (nausea)
  • neurological system
  • kidney liver
  • blood vessels
  • reproductive system
38
Q

How can long COVID be prevented?

A

strong evidence that COVID-19 vaccination lowers risks for long-term COVID-19 (seen in all age groups)

39
Q

What are some clinical trials on going to treat long COVID?

A
  • intravenous antibodies
  • oral pill to treat heart rate (Ivabradine, already existing drug)
  • high-salt diet

Drug final (14 decks)

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