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Flashcards in Antivirals Deck (29):
1

Inhibitors of Viral Attachment, Uncoating or Release (list)

Pleconaril
Docosanol
Amantadine
Rimantadine
Osteltamivir
Zanamivir

2

Name 2 inhibitors of viral attachment (inhibit viral uncoating)

Amantadine
Rimantadine

3

What are Amantadine and Rimantadine used for?

Used for treatment and prophylaxis of *influenza type A, no effect on type B-lack M2
Amantadine also used in Parkinson's disease

4

Name 2 Neuraminidase Inhibitors

Oseltamivir and Zanamivir

5

What are Oseltamivir and Zanamivir used for?

Treatment of influenza A and B, duration 5 days. Also effective for prophylaxis.

6

Name one precaution for Zanamivir

inhalation of dry powder
May produce bronchospasms, careful in patients with asthma or COPD

7

What 2 drugs inhibit attachment?

Pleconaril
Docosanol (Abreva)

8

Pleconaril

Prevents attachment of the virus to the human cell
Prevents viral uncoating within the cell
Effective against picornavirus (common cold)
Not FDA approved—not used here, used in other countries

9

Docosanol (Abreva)

Prevents attachment of the virus to the human cell
OTC cream : recurrent oral/genital herpes
Begin treatment within 12 hours of prodromal symptoms or lesion onset

10

Drugs that Block DNA Synthesis from Viral DNA: Guanosine analogs

Acyclovir
Valacyclovir
Penciclovir
Famiciclovir
Ganciclovir

11

Drugs that Block DNA Synthesis from Viral DNA: adenosine analog

Vidarabine

12

Drugs that Block DNA Synthesis from Viral DNA: Cytosine analog

Cidfovir (used in CMV in HIV/AIDS patients)

13

Acyclovir and Valacyclovir

Treatment and Prophylaxis of:
Herpes simplex (type I and II) and zoster
Drug of choice for treatment of HSV infections
Acyclovir used prophylactically to prevent mucocutaneous HSV infection in seropositive patients undergoing immunosuppressive therapy

Genital herpes: Decrease viral shedding, systemic symptoms, and time to resolution
Varicella zoster- treatment
Used within 24hours of rash onset decreases symptoms by ~ 1 day- use in high risk patients

14

Penciclovir and Famciclovir (oral prodrug of Penciclovir)

Both used to treat Herpes Zoster, Herpes simplex type II, topical treatment of oral/labial herpes simplex virus

15

Which 2 antivirals are Category B in pregnancy?

Acyclovir and Penciclovir

16

Ganciclovir and Valganciclovir (Oral prodrug)

Phosphorylated by viral protein kinase in cytomegalovirus and by viral thymidine kinase in herpes simplex virus then further phosphorylated by host enzymes

Active against all herpes viruses
Treatment of CMV in immunocompromised patients
Neutropenia, thrombocytopenia, teratogenic –Cat C
Vitasert- an intraocular sustained release implant for CMV retinitis

17

Which 2 antiviral are category C in pregnancy?

Ganciclovir and Valganciclovir (Oral prodrug)

18

Vidarabine

Phosphorylated by host enzymes
Treatment of viral thymidine kinase resistance
Broad spectrum antiviral activity- herpes, pox viruses, rhabdoviruses, hepadenaviruses, some RNA tumor viruses

Primarily used for keratitis, keratoconjunctivitis due to HSV, life threatening herpes simplex virus, varicella zoster infections
N/V, bone marrow suppression, neurotoxicity, peripheral neuropathy

19

Cidofovir

Phosphorylated by host enzymes- so useful when viral thymidine kinase resistance has developed
Broad spectrum antiviral activity; herpes and pox viruses, adenoviruses, papilloma viruses, and hepadenavirus

Primary use for treatment of cytomegalovirus in AIDS patients who are intolerant, relapsed, or nonresponsive to ganciclovir or foscarnet
Acyclovir resistant mucocutaneous HSV infection
Neutropenia and nephrotoxicity

20

Thymidine analog

Idoxuridine- Topical- for HSV types 1 and 2 keratoconjunctivitis and recurrent epithelial keratitis

21

Nucleotide analog

Adefovir- does not require phophorylation
FDA approved for treatment of chronic active infections HepB

22

Foscarnet (method of action)

an inorganic phosphate analog
Directly inhibits DNA and RNA polymerases and reverse transcriptases- 100 x greater effect on viral vs human DNA polymerase.
Does not require phosphorylation- broad spectrum

23

Foscarnet (uses)

Active against all herpes viruses, influenza, and HIV
Primary uses: CMV infections, acyclovir resistant herpes simplex or varicella zoster

24

Ribavirin

purine nucleoside analog
Phosphorylated intracellularly by host cell enzymes
Ribavirin aerosol- treatment of RSV
Ribavirin plus peginterferon – for Hepatitis C

25

Interferons

immunomodulatory (affect our own cells too) and antiviral.

26

Dose limiting toxicities of Interferons

Neutropenia and anemia-want to check pts for this. Check baseline blood cell count
“Flu like syndrome”- fever, fatigue, myalgia

27

Interferon alpha and beta

produced by nearly all cells in response to viral infection

28

Interferon gamma

is produced by T-cells and NK cells in response to antigens and cytokines

29

Main action of interferons

Interferons mainly act to prevent translation of viral proteins