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ID Drugs > Antiviral Drugs > Flashcards

Antiviral Drugs Flashcards

1
Q

Influenza

A

Zanamivir, Oseltamivir (Tamiflu)

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2
Q

What do Zanamivir and Oseltamivir (Tamiflu) inhibit?

A

Neuraminidase (unique to influenza virus)
Enzyme that cleaves sialic acid from glycoproteins
Required step in exit from infected cells

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3
Q

Zanamivir and Oseltamivir (Tamiflu) are only effective if

A

Administered w/n 48 hours of onset

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4
Q

Ribavirin is an analog of

A

Guanosine

Base attached to ribose has been changed

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5
Q

Ribavirin inhibits

A

RNA Polymerase

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6
Q

Ribavirin is triphosphorylated by

A

Cellular kinase enzymes

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7
Q

What enzyme (besides RNA Polymerase) does Ribavirin inhibit?

A

`IMP dehydrogenase

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8
Q

Ribavirin is an analog of guanosine and what else?

A

IMP: Biochemical intermediate that gets converted into guanosine

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9
Q

Ribavirin MOA

A

Mimics IMP. Once bound to IMP dehydrogenase, guanosine nucleotides essential for viral replication can no longer be synthesized.

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10
Q

Ribavirin uses

A 
RSV
Hep C (with interferon)
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11
Q

Ribavirin S/E

A

Hemolytic Anemia

Drug accumulates in RBCs and phosphorylates, contributing to ATP deficiency

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12
Q

Which antiviral drug is highly teratogenic?

A

Ribavirin

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13
Q

Acyclovir inhibits

A

herpes virus DNA polymerase

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14
Q

Acyclovir mimics what to terminate chain growth?

A

Guanosine

Acyclovir is missing a ribose sugar

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15
Q

What allows Acyclovir to target only infected cells?

A

Phosphorylated by herpes virus thymidine kinase

Becomes acyclovir monophosphate, which becomes triphosphate due to cellular kinases

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16
Q

Acyclovir phosphate is an analog of

A

deoxyguanosine triphosphate (dGTP)

17
Q

What is the difference between Acyclovir and Famciclovir?

A

Longer half-life so lower dose can be used

18
Q

What is a prodrug of Acyclovir?

A

Valacyclovir

Has greater bioavailability so lower dose can be used

19
Q

What is the risk of giving Acyclovir via IV?

A

Nephrotoxicity (crystallizes in urine)

Must give with IV fluids

20
Q

Acyclovir is effective for

A

HSV-1, HSV-2 and VSV

21
Q

Acyclovir is not effective for what herpes viruses?

A

CMV and EBV

Have different viral kinase

22
Q

Which drugs inhibits CMV DNA polymerase?

A

Ganciclovir, Foscarnet, Cidofovir

23
Q

Ganciclovir has a similar MOA to

A

Acyclovir (guanosine analog)

24
Q

How does Ganciclovir become ganciclovir 5’-monophosphate?

A

IC conversion by CMV viral kinase

25
Q

Ganciclovir monophosphate becomes triphosphorylated by

A

cellular enzymes

26
Q

Major toxicity of Ganciclovir

A

Bone marrow suppression, especially leukopenia

Inhibits bone marrow DNA polymerase

27
Q

What is a prodrug of Ganciclovir?

A

Valganciclovir

Better bioavailability so can administer lower dose

28
Q

Ganciclovir is primarily administered via

A

IV due to poor bioavailability

29
Q

Valganciclovir is often preferred to Ganciclovir because

A

It can be administered orally (better bioavailability)

30
Q

Foscarnet

A

Pyrophosphate analog

Binds/inhibits DNA Polymerase

31
Q

Foscarnet is used when

A

Gancicovir fails

Acyclovir-resistant HSV and VSV

32
Q

Foscarnet S/E

A

Nephrotoxicity
Calcium chelation (hypocalcemia)
Induces renal wasting of Magnesium (hypomagnesaemia)
Seizures (related to electrolytes)

33
Q

Cidofovir is an analog of

A

Cytidine

Cidofovir missing ribose sugar

34
Q

Cidofovir inhibits

A

DNA polymerase through cellular phosphorylation (no viral kinase needed)

35
Q

What is the main use of Cidofovir?

A

CMV retinitis

36
Q

What is the main toxicity of Cidofovir?

A

Renal failure

co-administer with saline and probenecid

37
Q

Interferons

A

Cytokines

Glycoproteins synthesized by infected cells and lymphocytes

38
Q

Interferon-alpha primes cells to fight against

A

Viruses

39
Q

Interferon-alpha used for

A 
Hep B and C
Kaposi sarcoma (HHV-8)

ID Drugs (7 decks)

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