Antivirals Flashcards Preview

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Flashcards in Antivirals Deck (44):
1

Amantadine MOA and Use

blocks attachment, penetration, and uncoating of Influenza A
use: prophylaxis, reduces duration of flu by 1-2 days

2

SE of Amantadine

atropine-like peripheral effects, livedo reticularis

3

Enfuvirtide MOA and use

binds gp41 and inhibits fusion of HIV1 to CD4 cells (chemokine receptor but drug is large enough to block gp120 which blocks fusion)

4

Maraviroc moa and use

blocks CCR5 protein on T cell membrane to prevent viral entry
use: HIV

5

Acyclovir moa

phosphorylation by THYMIDINE KINASE --> incorporated into DNA molecule--> chain terminator (lacks 3'OH)
*inhibits DNA polymerase

6

Acyclovir resistance

changes in DNA polymerase or decreased TK activity

7

Acyclovir uses

HSV
VZV

8

Why might a patient need multiple treatments with acyclovir?

it only works on dividing virus so if it is dormant, it is not killed

9

SE of Acyclovir

crystalluria, neurotoxicity
* NOT hematotoxic

10

Name the viral DNA polymerase inhbitors

acyclovir
famciclovir
valacyclovir
ganciclovir
foscarnet
**pro-drugs

11

What are the newer versions of acyclovir? Why would you use them?

famciclovir
valacyclovir
longer t1/2 than acyclovir
may work on acyclovir resistant strains as long as they have TK

12

Gancyclovir use

HSV, VZV: uses Tk for phosphorylation
CMV: uses phosphotransferase
**prophylaxis and tx of CMV in AIDS and transplantation

13

Gancyclovir SE

dose limiting hematotoxicity (leukopenia), mucositis, fever, rash, crystalluria (nephrotox), seizures (neurotox)

14

Foscarnet MOA

NOT an anti-metabolite
blocks DNA and RNA polymerases
*doesn't require TK

15

Foscarnet use

acyclovir-resistant HSV
CMV, VZV

16

Foscarnet SE

dose limiting acute tubular necrosis, hypocalcemia

17

Foscarnet drug interactions?

Pentamidine, will cause hypocalcemia
furosemide

18

Ribivarin MOA

monophosphorylase inhibits IMP dehydrogenase, triphosphorylated inhibits viral RNA polymerase

19

Ribivarin SE

hematotoxic, upper airway irritation, teratogenic!

20

Ribivarin use

adjunct to alpha interferon
Hep C
RSV
Lassa fever
hantavirus

21

What is an NRTI?

nucleoside reverse transcriptase inhibitor
pro-drugs
chain terminators
activated by nonspecific kinases
use with protease inhib. --> HAART

22

What is HAART?

highly active acute retroviral therapy
uses NRTI + protease inhibitor

23

What is the moa of NRTIS?

competes with natural nucleotides to inhibit reverse transcriptase and can also be incorporated into DNA to cause chain termination

*all work in the same way just with different base analogs

24

NRTI resistance?

mutation in gene for reverse transcriptase
there isn't complete cross resistance between different NRTIs

25

Zidovudine

NRTI
SE: bone marrow suppression (SEVERE), headaches, fatigue, myalgias

26

Other names for Zidovudine

Azidothymidine, ZDV, AZT

27

Didanosine names and SE

DD1
SE: pancreatitis, peripheral neuropathy

28

Abacavire

NRTI
SE--> allergies
aka: ABC

29

zalcitabine

NRTI
aka: DDC
SE: peripheral neuropathy
pancreatitis
*don't combine with didanosine

30

lamivudine

NRTI
aka: 3TC
SE: least toxic, some GI sx
also used in Hep B

31

Emtricitabine

newer, more active version of lamivudine
aka FTC

32

Stavudine

NRTI
aka: D4T
dont use with AZT because they have the same base analog
Se: myelosuppression, peripheral neuropathy

33

NNRTI

not pro-drugs
no myelosuppression
additive/ synergistic with NRTIs

34

Nevirapine

NNRTI
single does at delivery decreases transmission of HIV from mom to baby (vertical transmission) by 50%
CYP450 inducer
SE: rash, increased LFT

35

Efavirenz

NNRTI
SE: insomnia, nightmares (dysphoric dreams)

36

Viral aspartate protease inhibitors moa

aspartate protease enzyme contains dipeptide structure that isn't human form so it binds here to inhibit it

37

Viral aspartate protease inhibitors resistance

point mutations in pol gene, incomplete cross resistance

38

Common SE of Viral aspartate protease inhibitors

disordered lipids and carb metabolism with central adiposity and insulin resistance
*less with atazanavir

39

Indinavir

Viral aspartate protease inhibitor
used most frequently
SE: crystalluria

40

Ritonavir

Viral aspartate protease inhibitor
used most frequently
SE: major drug interactions from P450 induction

41

Saquinavir

Viral aspartate protease inhibitors
least toxic
low bioavailability
predisposes to resistance

42

viral neuraminidase inhibitors

influenza A and B
decreases liklihood that virus will penetrate uninfected cells
use: prophylaxis may decrease flu sx
SE: flu sx

43

Raltegravir

integrase inhib.
prevents integration of viral genome into host DNA
Use: HIV

44

Human interferons use

Hep B, C, D (alpha interferon)
Kaposi sarcoma, CML, MM, RCC (alpha)
MS (beta)
Chronic granulomatous disease (gamma)