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Pharm 5 > Antiviral Agent > Flashcards

Antiviral Agent Flashcards

(39 cards)

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1
Q

How do viruses work

A
  1. Binding and fusion of virus w/ host cell
  2. Penetration-uncoating and release of genetic material
  3. Insertion into host genome via integrase
  4. Genome replication
  5. Expression of viral proteins and protein processing
  6. Assembly of virus in host cell
  7. Release of virus from host

Viruses are obligate intracellular pathogens

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2
Q

Types of viral genome replication

Examples of each

A

DNA→DNA→mRNA

DNA pol

Herpes, CMV, varicella

DNA→RNA→DRNA

DNA pol, RNA dep DNA pol

HBV

+RNA→mRNA

HCV, HAV

-RNA→mRNA, +RNA template

RNA dep RNA pol

RSV, ebola

+RNA→DNA→+RNA

Reverse transcriptase

HIV

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3
Q

Viral infections

A

Many not life threatening

Some only show up when damage has been done-untreatable until damage is done (polio, resp. viruses)

Best tx for preventing/limiting viral inf is immunization (polio, MMR, smallpox, HPV)

Chronic viral inf. that can be treated:

  • Herpes
  • Varicella zoster
  • CMV
  • RSV
  • Influenza
  • HIV
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4
Q

What drugs are used to treat herpes infections?

A

Ciclovirs

Cyclovirs

Cidofovir

Foscarnet

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5
Q

Acyclovir

A

Antiviral drug

Tx: Herpes simplex and zoster

Mech: Incorporated into DNA and inh. viral DNA pol

Prodrug-must be phosphorylated by viral kinase

Only occurs in active cells

Much higher affinity for viral DNA pol

Route: IV and oral (not well absorbed though)

SE:

  • GI upset
  • Renal damage
  • CNS problems
    • Delerium when given IV
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6
Q

Valacyclovir

A

Antiviral drug

Tx: Herpes simplex and zoster

Mech: Prodrug converted to acyclovir

Must be given orally-prodrug metab. by 1st pass metab.

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7
Q

Famciclovir

A

Antiviral agent

Tx: herpes simplex and zoster

Mech: prodrug converted to acyclovir analog

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8
Q

Ganciclovir

A

Antiviral agent

Tx: CMV (herpes virus)

CMV→retinitis+ blindness

Mech: Inhibits viral DNA pol

Prodrug-activated by viral kinase

SE:

  • Neutropenia
  • Thrombocytopenia
  • Teratogen
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9
Q

Valganciclovir

A

Antiviral agent

Tx: CMV (herpes virus)

CMV→retinitis+ blindness

Mech: Inhibits viral DNA pol

Prodrug-converted to ganciclovir by viral kinase

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10
Q

Cidofovir

A

Antiviral agent

Tx: CMV (herpes virus)

CMV→retinitis+ blindness

Mech: Inhibits viral DNA pol

Prodrug-converted by host kinase

Used if resistance has occured so that host cells convert prodrug

SE: Renal damage

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11
Q

Foscarnet

A

Antiviral agent

Tx: CMV (herpes virus)

CMV→retinitis+ blindness

Mech: Inhibits viral DNA pol

Not a prodrug–directly inh. DNA pol

Route: IV 3x/day

SE: Renal damage

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12
Q

Agents used to treat Hep B

Names and mech

A

LATTE:

Lamivudine

Adefovir

Telbivudine

Tenofovir

Entecavir

Mech: Inh. Hep B reverse transcriptase

  • I HRT LATTE*
  • Inh. hep B rev. trans.–LATTE*
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13
Q

Lamivudine

A

Antiviral agent

Tx: Hep B

Mech: Inh. Hep B reverse transcriptase

Discontinuation→Increase hepatitis symptoms

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14
Q

Adefovir

A

Antiviral agent

Tx: Hep B

Mech: Inh. Hep B reverse transcriptase

SE: Liver and renal damage

Discontinuation→Increase hepatitis symptoms

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15
Q

Telbivudine

A

Antiviral agent

Tx: Hep B

Mech: Inh. Hep B reverse transcriptase

SE:

  • Lactic acidosis
  • Hepatomegaly

Discontinuation→Increase hepatitis symptoms

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16
Q

Tenofovir

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A

Antiviral agent

Tx: Hep B

Mech: Inh. Hep B reverse transcriptase

SE:

  • Lactic acidosis
  • Hepatomegaly

Discontinuation→Increase hepatitis symptoms

17
Q

Entecavir

Study These Flashcards
A

Antiviral agent

Tx: Hep B

Mech: Inh. Hep B reverse transcriptase

SE:

  • Lactic acidosis
  • Hepatomegaly

Discontinuation→Increase hepatitis symptoms

18
Q

Ribavirin

Study These Flashcards
A

Antiviral agent

Tx: RNA virus (RSV)

Only for severe lower resp inf.

Mech: Inh RNA dep DNA pol

Phosphorylated in cell.

SE:

  • Preg cat X
  • Hemolytic anemia
  • Decrease pulmonary fxn in infants
  • Cardiac arrest

Not used much anymore. Very expensive

19
Q

Palivizumab

Study These Flashcards
A

Antiviral agent

Tx: RNA virus (RSV)

Mech: vs antigenic site of RSV–blocks fusion of virus w/ target

Only used prophylactically

20
Q

Amantadine

Study These Flashcards
A

Antiviral agent

Tx: RNA virus (Influenza A virus)

Virus taken up by cell endosome→opens channel in endosome→H enters→virus can release genes

Mech: Blocks process by which H channel forms in endosome

Blocks transporter or ion channel

Used proph. or very early

SE:

  • Renal failure
  • Teratogen
  • CNS fx
    • Dizziness
    • Slurred speech
    • Confusion
    • Seizures
    • Nausea
21
Q

Rimantadine

Study These Flashcards
A

Antiviral agent

Tx: RNA virus (Influenza A virus)

Virus taken up by cell endosome→opens channel in endosome→H enters→virus can release genes

Mech: Blocks process by which H channel forms in endosome

Blocks transporter or ion channel

Used proph. or very early

Widespread resistance

SE: Fewer than amantidine but similar SE

  • Renal failure
  • Teratogen
  • CNS fx
    • Dizziness
    • Slurred speech
    • Confusion
    • Seizures
    • Nausea
22
Q

-amivir

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A

Zanamivir

Oseltamivir

Antiviral agent

Tx: Influenza A+B virus (RNA virus)

Virus leaves cell and is attached by tether of neuraminic acid

Release of virus requires neuraminidase

Mech: Neuraminidase inh.

So virus cannot be released from cell and spread

SE:

  • Nausea
  • Diarrhea
  • Psychosis
  • Hallucinations
  • Zanamivir is a powder that must be inhaled so asthma issues

Only shorten influenza by about a day

23
Q

Recombinant interferon alpha

Study These Flashcards
A

Antiviral agent

Tx: Hepatitis virus (esp Hep C)

Cytokine w/ multiple mech

Mech:

  • Immunostimulant
  • Inh. mRNA processing
  • Decrese viral synth

SE:

  • Fatigue
  • Flu-like symptoms
  • Depression
  • Hypertensino
  • Retinopathy
  • Myelosuppression→fewer platelets, granulocytes, etc.
24
Q

-previr

Study These Flashcards
A

Boceprevir

Telaprevir

Simeprevir

Antiviral agent

Tx: Hepatitis virus (esp Hep C)

Mech: HCV protease inh.

Virus makes proteins but cannot be processed to final stage

Used in comb. w/ interferon

25
Sofosbuvir
Antiviral agent Tx: Hepatitis virus (esp Hep C) Mech: Inh HCV RNA dep RNA pol Ledipasvir+Sofosbuvir=harvoni
26
Ledipasvir
Antiviral agent Tx: Hepatitis virus (esp Hep C) Mech: Binds to and inh. protein thats necessary for HCV replication Ledipasvir+Sofosbuvir=harvoni
27
Harvoni
DOC for HCV Ledipasvir+sofosbuvir
28
Nucleoside analog reverse transcriptase inh (NRTIs)
DAZLES T Didanosine Abacavir Zidovudine Lamivudine Emtricitabine Stavudine Telbivudine *(Tenefovir=nucleo**T**ide analog of RT inh)* \**Nucleotides do not have to be processed like nucleosides\* * Tx: HIV Mech: Inh reverse transcriptase Nucleoside analog--competetive inh. Phosphorylated in cell SE: * Life threatening hepatomegaly * Systemic lactic acidosis * Anemia * Myopathy * Pancreatitis * Some neuropathy * Daves got flow* * DAVE PHLOA* ***D**idanosine* ***A**bacavir* ***V**udine* ***E**mtricitabine* ***P**ancreatitis* ***H**epatomegaly* ***L**actic acidosis* *-**O**pathy (retin- +my-)* ***A**nemia*
29
Non nucleoside analog reverse transcriptase inh (NNRTIs) 1st gen
Nevirapine Delavirdine Efavirenz Tx: HIV Mech: Bind to non-active sites on reverse trans. Non competetive inh.
30
Non nucleoside analog reverse transcriptase inh (NNRTIs) 2nd gen
Etravirine Rilpivirine Tx: HIV Mech: Bind to non-active sites on reverse trans. Non competetive inh. Differ from 1st gen: * Higher potency * Longer T1/2 * Fewer SE
31
Nevirapine
Antiviral agent Tx: HIV Mech: bind to non active sites and Inh reverse trans Not competetive inh. 1st gen NNRTI SE * Hepatotoxicity * Stevens Johnson syndrome
32
Delavirdine
Antiviral agent Tx: HIV Mech: bind to non active sites and Inh reverse trans Not competetive inh. _Not as effective_ 1st gen NNRTI SE * Hepatotoxicity * Stevens Johnson syndrome * _P450 inh._
33
Efavirenz
Antiviral agent Tx: HIV Mech: bind to non active sites and Inh reverse trans Not competetive inh. 1st gen NNRTI SE * CNS- so some people crush it up and smoke it * hallucinations * memory loss * Rash * Smoke **_EF_**avirenz to get **_EF_**fed up* * hallucinations and mem loss*
34
-virine
Etravirine Rilpivirine Antiviral agent Tx: HIV Mech: bind to non active sites and Inh reverse trans Not competetive inh. 2nd gen NNRTI Differ from first gen: * Higher potency * Longer T1/2 * Fewer SE
35
-navir
Antiviral agent Tx: HIV Mech: Protease inh. Prevent formation of active viral proteins from their peptide precursor Most inh. P450 Some are absorbed poorly via oral route and 18 capsules must be taken/day Ritonavir is most potent known P450 inh so it is given w/ the poorly absorbed protease inh to avoid taking so many Ritonavir given w/: SALTD * Saquinavir * Atazanavir * Lopinavir * Tipranavir * Darunavir SE: * Alter fat distribution * Loss of fat in face and limbs * Gain fait in gut, chest, and back * Increase diabetes * Some have sulfur groups→allergies * Tipranavir * Fosamprenavir
36
Enfuvirtide
Tx: HIV Mech: binds to specific site on virus that binds to target Fusion inhibitor SE: Insomnia
37
Maraviroc
Tx: HIV Mech: Blocks binding site on macrophage preventing entry of virus Fusion inhibitor SE: * Hepatotoxicity * Allergies * Increase MI
38
-gravir
Tx: HIV Mech: Inh. HIV-1 integrase Inh. insertion of viral genome into human Prevents propagation
39
HAART
Highly Active Anti Retroviral Therapy Protease inh NRTI NNRTI

Pharm 5 (4 decks)

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