Antibiotics VI (Antivirals) Flashcards Preview

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Flashcards in Antibiotics VI (Antivirals) Deck (28)
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1


What are the agents used to treat DNA viruses and their respective viruses?

 

  • Nucleoside analogs for HSV/VSV (acyclovir)
  • Nucleoside analogs for CMV (ganciclovir)
  • Pyrophosphate analog for HSV/VSV/CMV (Foscarnet)

2


What are the generalizable MOA of the antivirals for DNA viruses?

 

  • Typically prodrug
  • Require bioactivation
  • Active cogener binds to the nucleic acid polymerase
  • Cogener lacks essential functional group to continue replication
  • Termination of nucleic acid synthesis

3


What is a vital characteristic that applies to all antivirals?


The must have a greater affinity for viral activating enzyme than the mammalian counterpart

4


What is acyclovir active against?


HSV and VZV

5


What is ganciclovir effective against?


CMV in HIV patients

6


Which disease requires a higher dose of acyclovir? HSV or VZV?


VZV

7


Why is acyclovir so widely used? What are its SEs?


Relatively well-tolerated

 

CNS side effects (seizures, altered mental status) can occur if IV acyclovir is dosed inappropriately

8


What is the structure that ganciclovir mimics?


guanine analogue specifically for CMV

9


What is the main utility of ganciclovir?


Tx and prophylaxis of CMV retinitis in HIV

10


SEs of ganciclovir?

 

  • Neutropenia and Thrombocytopenia are major dose-dependent (and dose-limiting) toxicities
  • Adverse CNS effects

11


Serious complication of CMV in HIV patients?


CMV retinitis

12


What is the broad spectrum antiviral drug?


Foscarnet (pyrophosphate congener)

13


What is the spectrum of foscarnet?


HSV/VZV/CMV and RNA viruses including HIV

14


When would Foscarnet be used instead of acyclovir?


If acyclovir resistant-HSV/VZV strains are infectious agent

15


What are the most commonly used neuraminidase inhibitors?


Oseltamivir

16


What is oseltamivir used to treat?


Influenza A and B

17


How do neuraminidase inhibitors work?


Prevent viral release from host cells

18


When is prophylactic oseltamivir use considered?


Seasonal prevention for high risk populations (Nursing home patients), Post-exposure prophylaxis for family members at high risk for severe disease

19


What is the optimal treatment window for oseltamivir?


Within 1-2 days of Syx onset

20


SEs of oseltamivir?


Neuropsyciatric toxicity - when overprescribed

21


What are the nucleoside reverse transcriptase inhibitors for HIV?


Zidovudine (Retrovir) and Lamivudine

22


What is the non-nucleoside reverse transcriptase inhibitor used for HIV?


efavirenz

23


What are the HIV protease inhibitors?


Amprenavir, ritonavir

24


What are the protease inhibitors for HCV?


Bocepravir, telepravir

25


What two drugs are used for resistant strains of HIV?

 

  • Fusion inhibitor - enfurvitide
  • Integrase inhibitor - raltegravir

26


What are the side effects of protease inhibitor drugs?


Lipodystrophy syndrome: Major long term adverse effects from class are hyperglycemia, hyperlipidemia, and fat distribution

27


What is the general strategy for HIV Tx?


Combination Tx with many drugs

28


What is the most aggressive schema in HAART?


Two NRTIs, a NNRTI, and a protease inhibitor