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Antivirals Flashcards

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1
Q

Classes of HIV drugs

A

NRTI
NNRTI
Protease inhibitors
INSTIs

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2
Q

MOA of NRTI

A

nucleoside analog inhibits reverse transcriptase which inhibits cDNA

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3
Q

NRTI HIV drugs

A

Tenofovir disoproxil fumarate
Tenofovir alafenamide
Emtricitabine
Abacavir
Lamivudine

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4
Q

Special consideration for Abacavir

A

HLA-B5701 allele

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5
Q

AE’s of HIV NRTI

A

bone marrow suppression
pancreatitis
peripheral neuropathy
hepatotoxicity
lactic acidosis
nephrotoxicity

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6
Q

NNRTI HIV drugs

A

“-vir-“

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7
Q

AE’s of HIV NNRTI

A

depression
hepatotoxicity
QTc prolongation
IRIS

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8
Q

HIV protease inhibitor drugs

A

“-navir”

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9
Q

MOA of NNRTI

A

bind to reverse transcriptase and inhibit cDNA

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10
Q

MOA of protease inhibitors

A

bind to protease which inhibits protein cleavage and inhibits new viral progeny

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11
Q

AE’s of HIV protease inhibitors

A

PR prolongation
QTc prolongation
hyperglycemia
hepatotoxicity
hyperlipidemia
pancreatitis
increases bleeding (no hemophiliacs)
IRIS
Avoid in patients at risk of phenylketonuria
Caution w/ sulfa allergy

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12
Q

MOA of INSTIs

A

inhibit integrase which inhibits DNA transfer which inhibits new viruses

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13
Q

HIV INSTI drugs

A

“-tegr-“

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14
Q

Special consideration for raltegravir?

A

Avoid in patients at risk for phenylketonuria

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15
Q

AE’s of INSTIs

A

nephrotoxicity
lactic acidosis
hepatotoxicity
depression
IRIS

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16
Q

Classes of Influenza drugs

A

Neuraminidase inhibitors
Polymerase acidic protein endonuclease inhibitor

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17
Q

MOA of neuraminidase inhibitors

A

bind to viral neuraminidase which inhibits the release of virus from sialic acid and inhibits viral spreading

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18
Q

Neuraminidase inhibitor drugs?

A

Oseltamivir (Tamiflu)
Zanamivir (Relenza)
Peramivir (Rapivab)

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19
Q

Tamiflu: treatment or prophylaxis?

A

both

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20
Q

Relenza: treatment or prophylaxis?

A

both

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21
Q

Rapivab: treatment or prophylaxis?

A

treatment only

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22
Q

AE’s of Tamiflu?

A

Skin rxn
Neuropsych rxn

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23
Q

Special consideration for Relenza?

A

Not used in asthma/COPD

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24
Q

AE’s of Rapivab?

A

Skin rxn
hallucinations
neuropsych rxn

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25
MOA of PA protein endonuclease inhibitor?
inhibit endonuclease which inhibits insertion of viral RNA and inhibits viral replication
26
PA protein endonuclease inhibitor drug?
Baloxavir marboxil (Xofluza)
27
Xofluza: treatment or prophylaxis?
both
28
Special considerations for Xofluza?
Avoid with dairy, Ca, Mg, Fe, Se, Zn, Al
29
AE's of Xofluza?
Anaphylaxis urticaria neuropsych rxn
30
Classes of CMV drugs?
NRTI NNRTI
31
CMV NRTI drugs?
Ganciclovir Valganciclovir Cidofovir
32
CMV NNRTI drug?
Foscarnet
33
Which has a higher oral bioavailability: ganciclovir or valganciclovir?
Valganciclovir
34
AE's of Ganciclovir/Valganciclovir?
nausea vomiting bone marrow suppression sterility
35
AE's of Cidofovir?
nephrotoxicity neutropenia uveitis metabolic acidosis
36
What can be done to decrease the risk of nephrotoxicity with Cidofovir?
Prehydrate with saline Take Probenecid (gout rx): decreases renal tubular secretions
37
Special considerations for Cidofovir?
Do not take if sulfa allergic
38
AE's of Foscarnet?
nephrotoxicity electrolyte wasting (seizures) anemia neutropenia dizziness QTc prolongation
39
Hep A medications?
JUST VACCINES: havrix, vaqta
40
Hep B vaccines?
Recombivax Twinrix Engirex
41
Hep C vaccines?
There aren't any
42
Classes of Hep B drugs?
NRTI - for chronic Hep B
43
Hep B NRTI drugs?
Tenofovir Entecavir Adefovir Lamivudine
44
AE's of Hep B NRTIs
renal impairment IRIS decreased bone mineral density lactic acidosis hepatomegaly nausea vomiting diarrhea HA
45
Special considerations for Hep B NRTIs
Risk of acute Hep B after discontinuing therapy Monitor renal impairment Potential HIV resistance
46
Drug classes for Hep C?
RNA polymerase inhibitors NS5A protein inhibitors Protease inhibitors
47
1st line drugs for Hep C?
Epclusa and Mavyret (treats all 6 genotypes)
48
Hep C RNA polymerase inhibitor drugs?
" -buvir"
49
Hep C NS5A protein inhibitor drugs?
"-asvir"
50
NS5A protein inhibitor MOA?
bind to NS5A protein which inhibits RNA replication and inhibits viral progeny
51
Special consideration for NS5A protein inhibitors?
Bradycardia if taken w/ ambiodarone, BB, or patients with cardiac disease
52
AE's of NS5A protein inhibitors?
increased ALT increased bilirubin fatigue skin rash anemia HA nausea
53
Hep C protease inhibitor drugs?
" -pr(a/e)vir"
54
AE's of Hep C protease inhibitors?
SJS anemia HA neutropenia nausea dysgeusia
55
What are the mRNA vaccines for covid?
Pfizer and Moderna
56
MOA of mRNA vaccines?
mRNA encoded for viral spike protein enters host cell mRNA and triggers covid antigens which triggers antibody immune reponse
57
Novavax MOA?
directly inject version of spike protein which triggers antibody immune response
58
Monoclonal antibody drugs?
"-mab"
59
Why are monoclonal antibodies not very useful in treating covid?
Rapid genomic changes in spike protein antigenic components (new variants!)
60
non-vaccine PrEP for covid?
Evusheld
61
Convalescent plasma use in covid?
Processed blood plasma from donors who recovered from covid infections. Used for hospitalized immunocompromised patients only
62
Protease inhibitors for covid?
Paxlovid
63
Why does paxlovid have Ritonavir (an HIV drug)?
Ritonavir is a CYP3A4 inhibitor; slows metabolism of Nirmatrelvir, increases half life and serum concentrations
64
NRTIs for covid?
Lagevrio Remdesivir
65
Drug class for Herpes?
Antinucleoside inhibitors
66
MOA of anti nucleoside inhibitors?
nucleoside analogs get picked up by DNA polymerase and incorporated into DNA and inhibit full DNA replication
67
Herpes anti nucleoside inhibitor drugs?
Acyclovir Valcyclovir Famciclovir Panciclovir

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