Anti-viral drugs Flashcards
(54 cards)
1
Q
Which anti-viral therapy is assoc with inhibiting fusion of the virus?
A
- Attachment
- Maraviroc
- Penetration
- Enfuvirtide
2
Q
Which anti-viral therapy inhibit reverse transcriptase
A
- NRTIs
- Nucleoside/nucleotide reverse transcriptase inhibitors
- TDF (tenofovir), FTC (Emtricitabine), ABC (Abacavir), 3TC (Lamivudine), ZDV (Zidovudine, formally AZT), ddl (didanosine), d4t (Stavudine)
- NNRTIs
- Non-nucleoside/nucleotide reverse transcriptase inhibitors
- Nevirapine, Efavirenz, Delavirdine
3
Q
Which anti-viral therapy inhibits integrase
A
Raltegravir
4
Q
Which anti-viral therapy is a protease inhibitor?
A
- navir
- Lopinavir, atazanavir, darunavir, fosamprenavir, saquinavir, ritonavir, indianvir
5
Q
Which anti-viral therapy causes protein synthesis inhibtion?
A
Interferon-alpha
(treat HBV, HCV)
6
Q
Which 2 anti-viral therapy is used for viral uncoating inhibition?
A
Amatadine & Rimantadine
no longer useful for influenza due to inc resistance
7
Q
Which anti-viral therapy is used for inhibition of nucleic acid synthesis?
A
- Guanine nucleotide synthesis
- Viral DNA polymerase inhibitors
- Guanosine analogs
8
Q
What is the treatment for the following (name class of drug and drug it self)
- RSV, HCV
- CMV, HSV (acyclovire resistant)
- HSV, VZV
- CMV
A
- RSV, HCV
- Guanine nucleotide synthesisi: Ribavirin
- CMV, HSV (acyclovire resistant)
- Viral DNA polymerase inhibitor: Foscarnet, Cidofovir
- HSV, VZV
- guanosine analogs: Acyclovir, etc.
- CMV
- Guanosine analogs: Ganciclovir
9
Q
Which anti-viral therapy is assoc with inhibition of release of progeny virus?
Treatment for Influenza A, B
(Name class and type of drug)
A
-
Neuraminidase inhibitors
- Zanamivir
- Oseltamivir
10
Q
Which anti-viral therapy is clinically used for
- treatment of prevention of both influenza A & B
- define its MOA
A
- Zanamivir, oseltamivir
- inhibit influenza neuraminidase –> dec the release of progeny virus
11
Q
Which anti-viral therapy is clinically used for
- RSV, chronic hepatitis C
- What is its MOA
A
- Ribavirin
-
MOA: inhibits synthesis of guanine nucleotides
- by competitively inhibiting inosine monophosphate dehydrogenase.
12
Q
Which anti-viral therapy is assoc w/the following toxicity:
hemolytic anemia, severe teratogen
A
Ribavirin
13
Q
Which anti-viral therapy is clinically used to treat the following:
- HSV, VZV
- Weak activity against EBV
- No activity against CMV
- No effect on latent forms of HSV and VZV
A
Acyclovir, famciclovir, valcyclovir
14
Q
Which anti-viral therapy is used for the following:
- HSV induced mucocutanoues adn genital lesions as well as for encephalitis
- Prophylaxis for immunocompromised pts
- has a better bioavaliablitity
- What is used for herpes zoster?
A
-
HSV induced mucocutanoues adn genital lesions as well as for encephalitis
- Acyclovir, famciclovir, valacyclovir
-
Prophylaxis for immunocompromised pts
- Acyclovir, famciclovir, valacyclovir
-
has a better bioavaliablitity
- Valacyclovir
-
What is used for herpes zoster?
- Famciclovir
15
Q
Which anti-viral therapy is assoc with the following toxicity?
- Obstructive crystalline nephropathy
- Acute renal failure if not adequately hydrated
A
Acyclovir, Famciclovir, Valacyclovir
16
Q
Acyclovir, fumciclovir, valacyclovir
- define its MOA
A
- MOA
- Preferentially inhibits viral DNA polymerase by chain termination.
-
Monophosphorylated by HSV/VZV thymidine kinase and not phosphorylated in uninfected cells
- few adverse effects
- Guanosine analog
- Triphosphate formed by cellular enzymes
17
Q
Acyclovir fumciclovir valacyclovir
define its MOR
A
Mutated viral thymidine kinase
18
Q
Which anti-viral therapy is clinically used for
- CMV (especially in immunocompromised pts)
- Which drug has a better oral bioavaliability
A
- Ganciclovir
- Valganciclovir
19
Q
Which anti-viral therapy is assoc w/the following toxicity:
- Leukopenia, neutropenia, thrmobocytopenia, renal toxicity
- More toxic to host enzymes than acyclovir!
A
20
Q
Ganciclovir
- define MOA
- define MOR
A
- define MOA
- 5’ monophosphate formed by a CMV viral kinase
- Guanosine analog
- Triphosphate formed by cellular kinase
- preferentially inhibits viral DNA polymerase
- 5’ monophosphate formed by a CMV viral kinase
- define MOR
- Mutated CMV DNA polymerase or lack of viral kinase
21
Q
Which of the following anti-viral therapy is clinically used for
- CMV retinitis in immunocompromised pts when ganciclovir fails
- acyclovir resistant HSV
A
Foscarnet
22
Q
Which anti-viral therapy is assoc with:
- Viral DNA polymerase inhibitor that binds to the pyrophosphate-binding site of teh enzyme
- Does it require activation by viral kinase?
A
- Foscarnet
- Does NOT require activation by viral kinase
23
Q
Foscarnet
- define its MOR
- define toxicity
A
- mutated DNA polymerase
- nephrotoxicity
24
Q
Which anti-viral therapy:
is co-administed with probenecid and IV saline to dec toxicity (Nephrotoxicity)
A
Cidofovir
25
Which antiviral therapy would you use to treat the following
* CMV retinitis in immunocompromised pts
* acyclovir resistant HSV
* long half-life
Cidofovir
26
Which anti-viral therapy
* Perferentially inhibits viral DNA polymerase
* Does not require phosphorylation by viral kinase
Cidofovir
27
What is initatiated when pts present with AIDs defining illness, low CD4 cell counts (\<500 cells/mm3) or high viral load
HAART (highly active antiretroviral therapy)
28
HAART therapy regimen consists of 3 drugs to prevent resistance:
what are they?
* 2 nucleoside reverse transcriptates (NRTIs)
* 1 Non-nucleoside reverse transcriptates inhibitor (NNRTI)
* Or 1 protease inhibitor
* Or 1 integrase inhibitor
29
Which antiviral therapy has the following toxicity
* Hyperglycemia, GI intolerance (nausea,diarrhea), Lipodystrophy
* Nephropathy, hematuria _ (**which specfic drug**)_
Protease inhibitors
* Atazanavir, Darunavir, Fosamprenavir, Indinavir, Lopinavir, Ritonavir, Saquinavir
* **Indinavir **causes hematuria
30
How does protease inhibitors prevent maturation of new viruses?
Assembly of virions depends on HIV-1 protease (pol gene) which cleaves the polypeptide products of HIV mRNA into their functional parts.
By stoping this rxn the virus is unable to exit the cell :-)
31
Which Protease inhibitor can boost other drug concentrations by inhibiting cytochrome P-450.
Ritonavir
32
Which anti-viral has the following toxicity:
* bone marrow suppresion (can be reverse by G-CSF (granulocty-colony stimulating factor) and erythropoietin).
* peripheral neuropathy
* lactica acidosis (nucleosides)
* rash (non-nucleosides)
* anemia (**which drug**)
* pancreatitis (**which drug**)
NRTI (nucleotides/nucleoside reverse transcriptase inhibitors)
* ABC (abcavir), ddI (Didansoine), FTC (emtricitabine), 3TC (Lamivudine), d4T(Stavudine), TDF (Tenofovir), ZDV, formerly AZT (Zidovudine).
* anemia: **ZDV (Zidovudine)**
* pancreatitis: **ddI (Didansoine)**
33
Which antiviral therapy:
competitvely inhibit nucleotide binding to reverse transcriptase and terminate the DNA chain (lack a 3' OH group).
NRTI's
34
Out of the NRTIs which drug is a nucleotide; compared to the rest which are nucleosides?
*Thus would not need to be phosphorylated to be active, like the nucleosides need to be.*
TDF (Tenofovir)
35
Which anti-viral therapy inhibits HIV genome integration into host cell chromosme by reversibly **inhibiting HIV integrase**?
Raltegravir
36
Which NRTIs is used for general prophylaxis and during pregnancy to dec risk of fetal transmission?
ZDV (**zidovudine**, formerly known as AZT)
37
Which anti-viral therapy is assoc with the following toxicity:
*Name the class and drugs assoc*
* Rash and hepatotoxicity are common
* Vivid dreams and CNS symptoms are common with which drug?
* Which two are contraindicated in pregnancy
NNRTIs
* Efavirenz, Nevirapine, Delavirdine
* **Efavirenz** (assoc with vivid dreams)
* **Efavirenz and Delavirdine**
38
Which anti-viral therapy
bind to reverse transcriptaets at a site different than another anti-viral therapy
Does not require phophorylation to be active or compete with nucleoties
NNRTIs
(non-nucleoside reverse transcriptase inhibitors)
39
Which anti-viral therapy agent is assoc with the following toxicity:
hypercholesterolemia
Raltegravir
40
Which anti-vral therapy
binds to gp41 inhibiting viral entry
Enfucirtide
41
Which anti-viral therapy
binds to CCR-5 on surface of T-cells/monocytes, inhibiting interaction with gp120
Maraviroc
42
which anti-viral therapy is assoc with the following toxicity:
skin rxn at injection sites
Enfuvirtide
43
anti-viral therapy
glycoproteins normally synthesized by virus-infected cells, exhibiting a wide range of antiviral and antitumoral properties
Interferons
44
which interferon is used to treat
HBV, HCV, HCL (Hairy Cell leukemia), condyloma acuminatum (genital warts), RCC (renal cell carcinoma), Malignant melanoma
IFN-alpha
45
Which interferons is used to treat
MS (mutiple sclerosis)
IFN-beta
46
Which interferon is used to treat
CGD (chronic granulomatous disease)
IFN-gamma
47
What are the 2 toxicitys of IFN
* Neutropenia
* Myopathy
48
What are the antibiotics to avoid in pregnancy
SAFe Children Take Really Good Care
* **S**ulfonamides
* **A**minoglycosides
* **F**luoroquinolones
* **C**larithromycin
* **T**etracyclines
* **R**ibavirin (antiviral)
* **G**riseofulvin (antifungal)
* **C**hloramphenicol
49
Which antibiotic is assoc with the following adverse affect:
## Footnote
**Kernicterus**
Sulfonamindes
50
Which antibiotic is assoc with the following adverse affect:
Ototoxicity
Aminoglycosides
51
Which antibiotic is assoc with the following adverse affect:
Cartilage damage
Fluroquinolones
52
Which antibiotic is assoc with the following adverse affect:
Discolored teeth, inhibition of bone growth
Tetracycline
53
Which antibiotic is assoc with the following adverse affect:
Teratogenic (2 drugs)
* Ribavirin (antiviral)
* Griseofulvin (antifungal)
54
Which antibiotic is assoc with the following adverse affect:
'Gray baby'
Chloramphenicol
