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Flashcards in Antivirals Deck (69):
1

Palivizumab

monoclonal antibody against F protein; prevents pneumonia caused by RSV in premature infants

2

HIV env protein

= gp120 (attachment) + gp41 (penetration)

3

fusion inhibitor that binds to gp41

Enfuviritide

4

fusion inhibitor that binds CCR5 on surface of T cells, inhibiting interaction with gp120

Maraviroc

5

Enfuviritide and Maraviroc are what?

fusion inhibitors

6

What is Raltegravir?

integrase inhibitor

7

What is -navir?

protease inhibitor

8

Nevirapine,
Efavirenz,
Delaviridine

NNRTIs

9

gag (p24) =

HIV capsid protein

10

What type of virus is HIV?

+ linear ssRNA

11

What is the only dsRNA virus?

Rotavirus (and coltivirus = colorado tick fever)

12

What does HIV bind on T cells?

CCR5 (early) or CXCR4 (late) and CD4

13

What does HIV bind on macrophages?

CCR5 and CD4

14

What mutation confers HIV immunity

homozygous CCR5

15

ELISA/Western blot may be falsely HIV+ for newborn because?

anti-gp120 crosses the placenta

16

HIV patient (CD4 <100) with low-grade fevers, cough, HSM, tongue ulcer; oval yeast forms within macrophages

Histoplasma

17

Normal CD4 count

500-1500

18

Hairy leukoplakia often presents on lateral tongue in HIV+ pt and is associated with

EBV

19

HIV + pt w/ superficial vascular proliferation in which biopsy reveals NEUTROPHILIC inflammation

Bartonella henselae (bacillary angiomatosis)

20

HIV+ pt (CD<200) with chronic watery diarrhea; acid-fast cysts in stool

Cryptosporidium

21

Many ring enhancing lesions in brain of HIV+ pt (CD4<100)

Toxo

22

Encephalopathy due to reactivation of latent virus in HIV+ pt (CD4< 200); results in demyelination

JC virus (causes PML)

23

HIV+ pt w/ meningitis

Cryptococus neoformans

24

HIV+ pt with retinitis

CMV

25

HIV + pt w/ superficial vascular proliferation in which biopsy reveals LYMPHOCYTIC inflammation

HHV8 - Kaposi sarcoma

26

HIV+ pt w/ interstitial pneumonia; biopsy reveals cells with intranuclear inclusion bodies

CMV

27

HIV+ pt w/ pleuritic pain, hemoptysis, infiltrates on imaging

Aspergillus

28

HIV+ pt w/ pneumonia w/ ground glass appearance on imaging

PCP

29

Pneumonia when CD4 count > 200

S pneumo

30

HIV pt w/ TB like disease, except that it grows well at 41C

Mycobacterium avium-intracellulare (MAC), prophylaxis is azithromycin

31

Inhibits influenza neuraminidase --> decreased RELEASE of progeny visions; used for treatment and prevention of influenza A + B

Oseltamavir, Zanamivir

32

Inhibits synthesis of guanine nucleotides by competitively inhibiting inosine monophosphate dehydrogenase;

Ribavirin

33

Ribivarin MOA

inhibits guanine synthesis by inhibiting IMP DH

34

Ribavirin CU

RSV, chronic HCV

35

Ribavirin SE

hemolytic anemia, severe teratogen

36

Guanosine analog that is phosphorylated by HSV/VZV thymidine kinase and not phosphorylated in uninfected cells --> few adverse effects. Triphosphate formed by cellular enzymes. Preferentially inhibits viral DNAP by chain polymerase by chain termination.

Acyclovir, famciclovir, valacyclovir (better oral availability)

37

Best drug for HSV

Acyclovir

38

Best drug for VZV

Famciclovir

39

Acyclovir SE

obstructive crystalline nephropathy and acute RF if not adequately hydrated

40

Acyclovir MOR

Mutated viral thymidine kinase

41

5' monophosphate formed by a CMV viral kinase. Guanosine analog. Triphosphate formed by cellular kinases. Preferentially inhibits viral DNAP

Ganciclovir

42

Best drug for CMV

Ganciclovir

43

Ganciclovir SE

leukopenia, neuropenia, thrombocytopenia, renal toxicity

44

Ganciclovir MOR

Mutated CMVP or lack of viral kinase

45

Drug for acyclovir resistant HSV and ganciclovir resistant CMV retinitis (immunocompromised patient)

Foscarnet

46

Viral DNAP inhibitor that binds to the pyrophophate-binding site of the enzyme. DOES NOT REQUIRE ACTIVATION BY A VIRAL KINASE

Foscarnet

47

Foscarnet SE

nephrotoxicity

48

Foscarnet MOR

mutated DNA polymerase

49

Viral DNAP inhibitor that does not require phosphorylation by viral kinase.

Cidofovir

50

Cidofovir CU

CMV retinitis in immunocompromise; acyclovir-resistant HSV

51

Cidofovir SE

Nephrotoxicity (coadminister w/ probenecid and IV saline)

52

Which protease inhibitor can booth other drug concentrations by inhibiting cyctochrome P450?

Ritonavir

53

Protease inhibitor SE

Hyperglycemia, GI intolerance, lipodystrophy

54

What protease inhibitor additionally has the side effects of nephrotoxicity and hematuria?

Indinavir

55

What NRTI does not need to phosphorylated to be active?

Tenofovir (nucleotides)

56

What is the prototypical NRTI that is used general prophylaxis and during pregnancy to decrease the risk of fetal transmission?

Zidovudine

57

NRTI SE

bone marrow suppression (can be reversed with G-CSF and epo), peripheral neuropathy, lactic acidosis (nucleosides), anemia (ZDV), pancreatitis (didanosine)

58

NNRTIS

Efavirenz
Nevirapine
Delaviridine

59

NNRTI MOA

bind to reverse transciptase at site different from NRTI. Do not require phosphorylation to be active or compete with nucleotides.

60

NNRTI SE

rash and hepatotoxicity

61

Efavirenz SE

Vivid dreams, CNS sympatoms

62

NNRTIs that are c/i in pregnancy

Delarviridine, Efavirenz
(leaves Nevirapine)

63

Inhibits HIV genome integration by reversibly inhibiting HIV integrase

Raltegravir

64

Raltegravir SE

Hypercholesterolemia

65

Glycoproteins normally synthesized by virus-infected cells, exhibiting a wide range of antiviral and anti tumor properties

IFNs

66

IFN-alpha CU

HBV + HCV

67

IFN-beta CU

MS

68

IFN-gamma CU

CGD

69

IFN SE

neutropenia, myopathy