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🄼💊Chemotherapy/AntiViral/Botanicals > Anti-Virals > Flashcards

Anti-Virals Flashcards

(56 cards)

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1
Q

[Abreva Docosanol] MOA

A

[Long chain alcohol] that disturbs HSV cell membrane –> DEC HSV entry

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2
Q

Most of theHerpes Family Drugs are _______. What makes Valacyclovir/ValGangcyclovir unique?

A

Anti-Herpes = Nucleoside Analogs

Val = added Valine (Proprodrug) –> INC PO bioavailability

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3
Q

Describe how the Herpes family may become drug resistant. What does this mean for outcome?

A

[Viral Thymidine Kinase] adds the first phosphate to Acyclovir –> [Acyclovir monophosphate] (human enzymes add the other 2).

Herpes virus with mutated TK –> Drug Resistance.

but…

Mutated TK Herpes –> viral weakness and so aren’t as common

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4
Q

Acyclovir MOA

A

[Acyclovir TriPhosphate] is a Guanosine analog that incorporates into replicating viral DNA –> Halts synthesis

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5
Q

Acyclovir Indication (2)

A

HSV

Zoster (shingles)

(IV for encephalitits)

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6
Q

Acyclovir SE (3)

A
  1. [Renal Damage w/rapid infusion (interstitial nephritis vs. crystalline nephropathy] (check pt hydration status)
  2. HA
  3. GI sx
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7
Q

How many DDI does Acyclovir have?

A

4 serious interactions with abx

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8
Q

Ganciclovir MOA

A

Herpes Guanosine analog, first phosphorylated by [Herpes UL97 kinase]–> Chain Termination

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9
Q

Ganciclovir Indication (5)

A
  1. [CMV Pizza Pie Retinitis - PO]
  2. [CMV Post Transplant Px - IV]
  3. [HHV6 and 7 Roseola]
  4. [HHV8 Kaposi Sarcoma]
  5. EBV
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10
Q

Ganciclovir SE (4)

A

u throw Bones in the Grass, u get a R**ash. U ThrowUp in the Grass and then u Pass

  1. [Bone Marrow Suppression]
  2. Rash
  3. NVD
  4. Neurotoxicity (rare)
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11
Q

How many DDI does Ganciclovir have?

A

4 serious interactions with abx

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12
Q

Foscarnet MOA

A

Fos = phos

[pyrophosphate binding site] blocker –> Directly inhibits [Viral DNA polymerase]

NOT FIRST LINE TX

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13
Q

Foscarnet Indication (5)

A

“Gonna play CHER Voice in my Fas Car”

  1. [HSV-Resistant]
  2. [CMV Pizza pie Retinitis - IV]
  3. Varicella Zoster
  4. EBV
  5. [HHV6 & 7 Roseola]
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14
Q

Foscarnet SE (4)

A

You’ll be saying AMEN, taking Fos For 2 long!

  1. NEPHROTOXIC (Glomeruli Crystals)
  2. Electrolyte Disturbances (DEC Ca+ and Mg+)
  3. Myelosuppression
  4. Anemia
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15
Q

How many DDI does Foscarnet have?

A

None

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16
Q

Foscarnet Pharmacokinetics

A

[2-4 hour short half life] but deposits in bone

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17
Q

PriTelivir MOA

A

PriTelivir (Pretty boy on sketchy) =

Inhibits HSV Helicase-Primase

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18
Q

PriTelivir Indication

A

HSV

Replaces Foscarnet as adjunct to Acyclovir-therapies

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19
Q

Direct Acting Antivirals are used to CURE ___.

NS3 describes which HCV enzyme

A

Direct Acting Antivirals are used to CURE Hep C

NS3 = Protease

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20
Q

Direct Acting Antivirals are used to CURE ___.

NS5-A describes which HCV enzyme

A

Direct Acting Antivirals are used to CURE Hep C

NS5-A = Phosphoprotein

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21
Q

Direct Acting Antivirals are used to CURE ___.

NS5-B describes which HCV enzyme

A

Direct Acting Antivirals are used to CURE Hep C

NS5-B = [RNA-dependent RNA Polymerase]

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22
Q

Which inhibiting components make up the [Multidrug DAA],

Viekira? (4)

A

PORD

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23
Q

Which inhibiting components make up the [Multidrug DAA],

Harvoni? (2)

Study These Flashcards
A

Ledipasvir (inhibits NS5-A)

SOfosbuvir (inhibits NS5-B)

24
Q

Which inhibiting components make up the [Multidrug DAA] that only inhibits NS3? (3)

Study These Flashcards
A

Sim, Tela & Boce

25
What is the [Multidrug DAA] Dose Regimen for Curing HCV. Which HCV genotype does this cure?
[1 PO QD x 12-24 weeks +/- Ribavirin and IFN-alpha] --\> Cures **HCV Genotype 1** only
26
[Multidrug DAA] SE (3)
Minor Fatigue Constitutional Insomnia
27
How many DDI does [Multidrug DAA] have?
[P-gp inducers] DEC [Multidrug DAA] effect
28
[Multidrug DAA] Pharmacokinetics
[1-2 Day half life] with renal elimination
29
Ribavirin MOA (3)
* Nucleoside Analog that...* 1. Depletes GTP pools 2. [Directly Blocks Viral RNA polymerase --\> viral replication errors] 3. Triggers CD8 activation
30
Ribavirin Indication (2)
1. HCV 2. RSV (**Non**-pregnant Adults)
31
Ribavirin SE (2)
1. [Severe Hemolytic Anemia] 2. Teratogenic
32
How many DDI does Ribavirin have?
**Toxic** when co-administered with [HIV RT inhibitors]
33
Ribavirin is typically only used in conjunction with \_\_\_\_\_
Ribavirin is typically only used in conjunction with **IFN-alpha** ## Footnote *IFN-alpha is at least 50% effective when with Ribavirin*
34
IFN-alpha MOA
Stimulates [DEC Protein Synthesis of neighboring cells] (host antiviral immunity) *IFN-alpha = Pegylated Interferon-alpha*
35
IFN-alpha Indication (2)
[Hep C: Genotypes **2 & 3**] (but can suppress all)
36
IFN-alpha SE (3)
* Flu-like sx * Depression * Cirrhosis exacerbation
37
How many DDI does IFN-alpha have?
**\> 200! and \> 20 are major! smh**
38
IFN-alpha Pharmacokinetics
PEG INC [IFN-alpha] lifetime x 10 --\> 3 Days long
39
Risk Factors for Progression of Hep B (3)
1. [Elevated HBV DNA + INC serum ALT] 2. [Male vs. Older vs. HCC fam hx] 3. Coinfection with [Hep C, D or HIV]
40
When is it indicated to treat a Hep B positive pt? (4)
1. [Liver Failure + chronic Hep B] 2. [Cirrhosis + chronic Hep B] 3. [HBV DNA \>105] + [INC ALT \>3 mo.] 4. [HBV DNA \>104] + [INC ALT \>3 mo.] + [E-antigen]
41
Entecavir MOA (3)
Guanosine analog that Inhibits **HBV** DNA priming / RT / DNA pol
42
Entecavir Indication
Hep B (including Lamuvidine resistant ones)
43
Entecavir SE (2)
Lactic Acidosis Rebound Hepatitis
44
Describe any DDI Entecavir has?
"GA *Tec* doesn't have Heart...so dont' give em HAART!" Can't be given with HAART
45
Entecavir Pharmacokinetics
LONG HALF LIFE and excreted via glomeruli
46
Tenofovir MOA **for Hep B**
Prodrug hydrolyzes to Adenosine analog --\> phosphorylated to Ten-PPP ---\> Inhibits **H**_B_**V** DNA pol *(but works as a NRTI in HIV)*
47
Tenofovir Indication (2)
HIV Hep B
48
Tenofovir SE (3)
Hep B Flare Nephrotoxic [Lactic Acidosis Hepatic Steatosis Syndrome]
49
Describe any DDI Tenofovir has?
Many DDI ## Footnote Watch for Nephrotoxicity and [Lactic Acidosis Hepatic Steatosis Syndrome]
50
[Amantadine & Rimantadine] MOA
**Prevents intracell Viral Uncoacting** by plugging [M2 ion channel]--\> Viral RNAs are not released into cell OBSOLETE DRUGS
51
[Amantadine & Rimantadine] Indication
Influenza A (70% of flu) OBSOLETE DRUGS
52
[Osel**tami**vir & Zanamivir] MOA
Neuraminidase inhibitors --\> prevents [sialic acid anchor] from being cleaved --\> **prevents release**
53
[Oseltami​vir & Zanamivir] Indication (2)
Influenza A **and** B
54
[Oseltami​vir & Zanamivir] SE (3)
1. GI Sx (including NV) 2. Insomnia 3. Vertigo
55
Route of Admin for [Oseltami​vir & Zanamivir]. Dose Regimen
[(Osel**tami**vir = PO) / (Zanamivir = Aerosol inhalant)] Postexposure Px: Start within 2 days of exposure and continue QD x 10 days vs. [6 weeks during outbreak]. This shortens Dz by 1-2 days
56
[Oseltami​vir & Zanamivir] Pharmacokinetics
"*Tami* tolerates it well. She reached her Climax in 1 hour!" Well tolerated; Reaches Peak Conc. in 1 hour

🄼💊Chemotherapy/AntiViral/Botanicals (4 decks)

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