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First Aid: Microbiology > Antiviral Therapy > Flashcards

Antiviral Therapy Flashcards

1
Q

Zanamivir, oseltamivir

mechanism

clinical use

A
  • inhibit influenza neuraminidase
  • decreases release of progeny virus
  • treatment & prevention of influenza A & B
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2
Q

Ribavirin

mechanism

A
  • inhibits synthesis of guanine nucleotides
  • competitively inhibits inosine monophosphate dehydrogenase
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3
Q

Ribavirin

clinical use

toxicity

A
  • RSV, chronic HepC
  • Hemolytic anemia, severe teratogen
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4
Q

Acyclovir, famciclovir, valacyclovir

mechanism

A
  • monophosphorylated by HSV/VZV thymidine kinase & not phosphorylated in uninfected cells
  • few adverse effects
  • guanosine analog
  • triphosphate formed by cellular enzymes
  • **preferentially inhibits viral DNA polymerase by chain termination **
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5
Q

Acyclovir, famciclovir, valacyclovir

clinical use

A
  • HSV, VZV
  • weak activity against EBV
  • no activity against CMV
  • HSV-induced mucocutaneous & genital lesions
  • encephalitis
  • prophylaxis in immunocompromised patients
  • valacyclovir
    • prodrug of acyclovir
    • better oral bioavailability
  • famciclovir - herpes zoster
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6
Q

Acyclovir, famciclovir, valacyclovir

toxicity

A
  • obstructive crystalline nephropathy
  • acute renal failure if not adequately hydrated
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7
Q

Acyclovir, famciclovir, valacyclovir

resistance

A

mutated viral thymidine kinase

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8
Q

Ganciclovir

mechanism

A
  • 5’-monophosphate formed by CMV viral kinase
  • guanosine analog
  • triphosphate formed by cellular kinases
  • **inhibits viral DNA pol **
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9
Q

Ganciclovir

clinical use

A
  • CMV (immunocompromised)
  • valganciclovir
    • prodrug
    • better oral bioavailability
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10
Q

Ganciclovir

toxicity

A
  • leukopenia
  • neutropenia
  • thombocytopenia
  • renal toxicity
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11
Q

Ganciclovir

resistance

A
  • mutated CMV DNA pol
  • lack of viral kinase
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12
Q

Foscarnet

mechanism

A
  • **viral DNA pol inhibitor **
  • binds pyrophosphate-binding site of enzyme
  • doesn’t require activation by viral kinase
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13
Q

Foscarnet

clinical use

A
  • CMV retinitis (immunocompromised) when ganciclovir fails
  • acyclovir-resistant HSV
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14
Q

Foscarnet

toxicity

resistance

A
  • nephrotoxicity
  • mutated DNA pol
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15
Q

Cidofovir

mechanism

A
  • preferentially **inhibits viral DNA pol **
  • doesn’t require phosphorylation by viral kinase
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16
Q

Cidofovir

clinical use

toxicity

A
  • CMV retinitis (immunocompromised)
  • acyclovir-resistant HSV
  • long t1/2

First Aid: Microbiology (13 decks)

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