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Pharmacology > Antivirals > Flashcards

Antivirals Flashcards

1
Q

Acyclovir (zovirax) MOA

A

Guanosine analogue.Inhibits DNA synthesis by competing with dGTP. Terminates the chain due to lack of 3 prime hydroxyl. Requires phosphorylation by viral thymidine kinase.

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2
Q

Herpes DOC

A

Acyclovir

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3
Q

Acyclovir resistance

A

decrease viral thymidine kinase so the drug can’t be activated by phosphorylation.

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4
Q

Acyclovir kinetics

A

oral/IV/topical. Short half life. Concentrated (trapped) in viral cells. Excreted by the kidney

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5
Q

Valcyclovir

A

pro-drug with higher bioavailability. Eventually converted into acyclovir.

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6
Q

Acyclovir uses

A

genital herpes, oral herpes, herpes keratitis, encephalitis, prophylaxis in organ transplants.

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7
Q

Acyclovir toxicity

A

nephrotoxicity with high IV doses (decreased with hydration), nausea/vomiting, HA. Safe to use during pregnancy.

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8
Q

Docosanol (Abreva) MOA

A

Inhibits viral fusion

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9
Q

Docosanol (abreva) uses

A

OTC topical preparation for cold sores

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10
Q

Ganciclovir/valganciclovier MOA

A

Guanosine analogue activated by viral kinases. inhibits DNA polymerase. Less active and more toxic than Acyclovir.

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11
Q

Ganciclovir kinetics

A

Ocular implant, IV, Oral.

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12
Q

valganciclovir kinetics

A

Oral prodrug.

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13
Q

Ganciclovir uses

A

CMV/Herpes in immunocompromised, CMV retinitis, Life threatening CMV infections.

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14
Q

Ganciclovir toxicity

A

myelosuppression (neutro, thrombo, leuko) especially when used with zidovudine for HIV. Severe HA, confusion and seizures.

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15
Q

Foscarnet (foscvir) MOA

A

directly inhibits DNA/RNA polymerase and reverse transcriptase. No need for phosphorylation (good for use in resistant strains).

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16
Q

Foscarnet uses

A

Back up for HSV/CMV that are resistant to acyclovir or ganciclovir.

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17
Q

Foscarnet toxicity

A

Renal, adjust the dose and hydration.

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18
Q

Cidofovir (vistide) MOA

A

Cytosine analogue that inhibits viral DNA polymerase. Phosphorylated independent of viral enzymes.

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19
Q

Cidofovir uses

A

Back up for resistant strains of CMV and HSV.

20
Q

Cidofovir toxicity

A

Dose dependent nephrotoxicity (hydration).

21
Q

Osteltamivir (tamiflu)/Zanamivier (Relenza) MOA

A

Neuraminidase inhibitor. Blocks the release of the virus from the host cell.

22
Q

Osteltamivir (tamiflu)/Zanamivier (Relenza) uses

A

Active against influenza A and B. Has to be used within 48 hours of symptom onset.

23
Q

Osteltamivir (tamiflu) administration

A

Oral. approved for >1 year of age. Also used for the bird flu.

24
Q

Osteltamivir (tamiflu) toxicity

A

nausea and vomiting (take with food)

25
Q

Zanamivier (Relenza) administration

A

nasal/oral inhaler. approved for >7 years of age.

26
Q

Zanamivier (Relenza) toxicity

A

Worsens COPD and asthma. Shouldn’t be given if patient has any airway disease.

27
Q

Amantadine (symmetrel)/Rimantadine (flumadine) MOA

A

inhibits viral uncoating

28
Q

Amantadine (symmetrel)/Rimantadine (flumadine) uses

A

prophylactic or symptomatic treatment of influenza A. Rarely used due to rapid development of resistance.

29
Q

Ribavirin (virazole) MOA

A

Guanosine analogue that inhibits RNA polymerase and synthesis of GTP. Independent of viral kinases for phosphorylation.

30
Q

Ribavirin (virazole) toxicity

A

hemolytic anemia, respiratory depression, cardiac arrest, IV use cause psychiatric issues. TERATOGENIC! even with occupational exposure.

31
Q

RSV DOC

A

Ribavirin (virazole)

32
Q

Ribavirin (virazole) uses

A

DOC for RSV. Also used to treat HCV along with interferon.

33
Q

Interferon-alpha2b (intron-A) MOA

A

Blocks EVERYTHING (entry, transcription, translation, replication, processing, assembly and release). Given IV/IM.

34
Q

PEG-interferon

A

Interferon-alpha2b (intron-A) that is long lasting and given as a depot prep once a week.

35
Q

Interferon-alpha2b (intron-A) uses

A

HCV with ribavirin and chronic HBV.

36
Q

Interferon-alpha2b (intron-A) toxicity

A

Flu-like symptoms, CNS depression and suicide (MUST prescrive with an antidepressant), hematologic, cardiac (hypotension and edema).

37
Q

Boceprevir (victrelis) MOA

A

Blocks serine proteases needed for replication of HCV.

38
Q

Boceprevir (victrelis) uses

A

Oral. Can be added to interferon and ribavirin to treat HCV.

39
Q

Boceprevir (victrelis) toxicity

A

ihibitor of CYP3A4, exacerbates anemia, neutropenia and fatigue associated with interferon/ribavirin treatment.

40
Q

HBV DOC

A

Lamivudine.

41
Q

Lamivudine MOA

A

inhibits HBV polymerase (reverse transcriptase inhibitor)

42
Q

Lamivudine use

A

DOC for chronic HBV can also treat HIV. Oral. few side effects.

43
Q

Adefovir MOA

A

inhibits HBV DNA polymerase.

44
Q

Adefovir toxicity

A

renal toxicity

45
Q

Entecavir MOA

A

Guanosine analogue. Inhibits HBV DNA polymerase.

Pharmacology (24 decks)

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