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Kaplan: Antimicrobial Agents > Antivirals > Flashcards

Antivirals Flashcards

1
Q

Which antiviral medications block viral penetration/uncoating?

A

amantadine (uncoating) , enfuviritide, maraviroc (penetration)

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2
Q

Which antiviral drugs inhibit viral DNA polymerases?

A

acyclovir, foscarnet, ganciclovir

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3
Q

Which antiviral drugs inhibit viral RNA polymerases?

A

Foscarnet, ribavirin

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4
Q

Which antiviral drugs inhibit viral reverse transcriptase?

A

zidovudine, didanosine, zalcitabine, lamivudine, stavudine, nevirapine, efavirenz

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5
Q

Which antiviral drugs inhibit viral aspartate protease?

A

indinavir, ritonavir, saquinavir, nelfinavir

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6
Q

Which of the antiviral medications inhibit viral integrase?

A

raltegravir

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7
Q

Which antiviral agent inhibit viral neuraminidase?

A

Zanamivir, oseltamivir

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8
Q

For viral drugs what is a trick to determine the use of most?

A

avir aids
ivir for influenza
over for “O shit I have herpes”

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9
Q

How can the herpes virus confer resistance to ovir agents?

A

can dec production thymidine kinase or completely get rid of TK (- TK strain)

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10
Q

S/E of acyclovir?

A

crystalluria mainly

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11
Q

Gancyclovir indication.

A

HSV, VZV, CMV

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12
Q

S/E gancyclovir?

A

crystalluria

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13
Q

MOA foscarnet and how it is different from ganciclovir and acyclovir?

A

not an antimetabolite so doesn’t need to be phosphorylated but does inhibit viral DNA and RNA polymerase

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14
Q

Describe the purpose of HAART in treating HIV?

A

HAART Highly active antiretroviral therapy:
decreases viral RNA,
reverses decline in CD4 cells
dec. the risk of opportunistic infections

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15
Q

What is tenofovir and what is it commonly coformulated with?

A

an NtRTI commonly formulated with an NRTI

has a single phosphate residue and must be further phosphorylated to the triphosphate form

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16
Q

Tenofovir unlike NRTIs doesn’t require what?

A

one phosphorylation step which is usually from the virus itself

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17
Q

What drug class does Zidovudine, AZT belong to?

A

NRTI

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18
Q

What drug class does Didanosine, DDI belong to?

A

NRTIs

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19
Q

what drug class does Lamivudine, 3TC; emtricitabine FTC belong to?

A

NRTIs

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20
Q

Zidovudine is what analog?

A

thymidine

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21
Q

Didanosine is an analog of what?

A

inosine

22
Q

Lamuvidine is an analog of what?

A

cytosine

23
Q

Major S/Es of NNRTIs?

A

vivid dreams, maculopapular rash

24
Q

S/E zidovudine?

A

Bone marrow supression

25
Q

S/E didanosine?

A

pancreatitis, peripheral neuropathy, hyperuricemia, liver dysfunction

26
Q

What are the S/E of lamuvidine and emtricitabine?

A

least toxic of NRTIs, but some GI effects and neutropenia

27
Q

Best HIV prophylaxis post exposure prophylaxis drugs?

A

emtricitabine + tenofovir + raltegravir

28
Q

Best regimen for HIV prophylaxis during pregnancy?

A

2 NRTIs (emtricitabine or lamivudine) + (zidovudine or tenofovir) + ritonavir-boosted atazanavir or lopinavir

29
Q

What is the best method to go about treating HIV in general?

A

Integrase inhibitors combined with 2 NRTIs are used as complete treatment regimens

30
Q

NNRTIs have additive or synergistic effects when used in combination with what other antivirals?

A

NRTIs or protease inhibitors

31
Q

MOA of PI (protease inhibitors) ?

A

aspartate protease (pol gene encoded) is a viral enzyme that cleaves precursor polypeptides in HIV buds to form the proteins of the mature virus core

32
Q

What are the S/Es of indinavir?

A

crystalluria

33
Q

S/E, in general, of most protease inhibitors?

A

syndrome of disordered lipid and CHO metabolism central adiposity and insulin resistance

34
Q

MOA Intergrase inhibitors?

A

prevents integration of viral genome in host cell DNA

35
Q

Suffix to remember the integrase inhibitors?

A

tegravirs

36
Q

Name the antiviral medications considered fusion inhibitors?

A

enfuvirtide, maraviroc

37
Q

Basic MOA of enfuvirtide and maraviroc?

A

block entry of HIV into cells

38
Q

MOA enfuvirtide?

A

binds to gp41 and inhibits the fusion HIV-1 to CD4+ cells

39
Q

MOA maraviroc?

A

blocks the binding of the gp120 HIV protein to CCR5 on macrophage surface to prevent viral entry

40
Q

Are amantadine and rimantadine still used for prophylaxis of influenza A?

A

no

41
Q

MOA zanamivir and oseltamivir (tamiflu)

A

inhibit neuraminidase of influenza A and B (enzymes that prevent clumping of virions so that more particles are available for infecting host cells)

42
Q

Indication zanamivir and oseltamivir?

A

prophylaxis mainly, but may decrease duration of flu symptoms by 2-3 days

43
Q

MOA ribavirin?

A

inhibits IMP dehydrogenase and RNA polymerase

44
Q

Indication for use of ribavirin?

A

combined with Alpha-interferons for hep C; Lassa fever and Hantavirus

45
Q

S/E of ribavirin use?

A

anemia

46
Q

MOA sofosbuvir? Use?

A

nucleotide analog that inhibits RNA polymerase;

Hep C

47
Q

What is Sofosbuvir usually combined with to make it more effective?

A

ribavirin or INT-a

48
Q

MOA of Simeprevir and use?

A

hepatitis C protease inhibitor

49
Q

What is simeprevir usually combined with?

A

ribavirin or INT-a

50
Q

What is the MOA of ledipasvir and use?

A

inhibits HCV NS5A protein that plays a key role in RNA replication and secretion

51
Q

What is the best way to remember the proteins associate with Hep C targets?

A

USE me for Hep C
USE backwards
Evir (NS3/4A)
Svir (NS5A)
Uvir (NS5B)

Kaplan: Antimicrobial Agents (5 decks)

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