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Flashcards in Anti-virals not in sketchy Deck (22):
1

What is the indication and MoA of docosanol?

Herpes cold sores

Long-chain alcohol that may disturb cell membranes and reduce herpes virus entry into cells

2

What is ganciclovir indicated for?

CMV
EBV
HHV-6
HHV-8

3

What are the indications for foscarnet?

HSV
CMV
VZV
EBV
HHV-6

4

A mutation in UL97 kinase would confer resistance to what drug? (Why?)
What would you use instead?

Ganciclovir (UL97 is CMV's viral kinase, required by ganciclovir)

Foscarnet

5

What are the adverse effects of foscarnet besides nephrotoxicity (crystals in glomeruli) and electrolyte disturbances?

Myelosuppression and anemia.

6

What is the MoA of pritelivir?

Helicase-primase inhibitor that blocks viral DNA replication

7

What is the indication for pritelivir?

HSV

8

What is the category for the best, newest anti-hepatitis drugs?

What were the 2 sketchy eg's?

What is their MoA?

Direct-acting antivirals (DAAs)

Sofosbuvir and simeprevir

Competitively inhibit (1*) viral protease. Inhibit (2*) viral RNA polymerase, allosterically or via chain termination.
Indireclty inhibit viral phosphoprotein activity.

9

What are the side effects of DAA's?

What can interfere with their effects?

Minor fatigue, headache, nausea, insomnia

P-gp inducers reduce therapeutic effect

10

When should IFN be used with caution?

If pt has cirrhosis

11

Name 2 drugs used to treat hBv

Entecavir
Tenofovir (TFV)

12

What is the MoA for entecavir?

Tenofovir?

Guanosine analogue; inhibits viral polymerase. Inhibits HBV DNA priming, RT and DNA polymerase

Prodrug hydrolyzes to adenine (dAMP) analog, then is phosphorylated to Ten-PPP, then blocks HBV DNA polymerase

13

What are the side effects of entecavir?

Tenofovir?

Lactic acidosis.
Rebound hepatitis

GI symptoms, fatigue, headache, renal failure

14

In which flu strains can amantadine/rimantadine possibly be used?

What about for oseltamivir/zanamivir?

Influenza A (not B or C)

Influenza A and B

15

What is the difference b/w oseltamivir and zanamivir?

Oseltamivir: Oral
Zanamivir: aerosol inhalant

16

What are the SE's of oseltamivir?

Zanamivir?

Osentamivir: Anxiety, disorientation, headache

Zanamivir: N/V, GI symptoms, insomnia, vertigo

17

What is palivizumab used for? (explain)

AB vs fusion protein of RSV

*Preventative vaccine for at-risk children (not a tx)

(Ribavirin is the nucleoside analogue tx, can't be used for kids/pregos. Also used for hep C)

18

What virus is pleconaril used to treat?

What's its mechanism of action?

Enterovirus D68 (a picovirus)

Becomes part of virus, changes virus shape, virus can no longer bind receptor to infect a new cell

19

What can be used as tx for Hep A?

Using the killed vaccine during prodromal period.

20

Tx for aplastic crisis during parvo infection?

IVIG in immunocompromised

21

When is letermovir used, specifically?

MoA?

CMV prophylaxis in transplant pts

Targets the terminase complex (can’t cleave DNA copy)

22

Recall: What does letemovir treat?
What does pritelivir treat?

Letemovir: CMV (prophylaxis)
Pritelivir: HSV