Flashcards in Antivirals Deck (69):
monoclonal antibody against F protein; prevents pneumonia caused by RSV in premature infants
HIV env protein
= gp120 (attachment) + gp41 (penetration)
fusion inhibitor that binds to gp41
fusion inhibitor that binds CCR5 on surface of T cells, inhibiting interaction with gp120
Enfuviritide and Maraviroc are what?
What is Raltegravir?
What is -navir?
gag (p24) =
HIV capsid protein
What type of virus is HIV?
+ linear ssRNA
What is the only dsRNA virus?
Rotavirus (and coltivirus = colorado tick fever)
What does HIV bind on T cells?
CCR5 (early) or CXCR4 (late) and CD4
What does HIV bind on macrophages?
CCR5 and CD4
What mutation confers HIV immunity
ELISA/Western blot may be falsely HIV+ for newborn because?
anti-gp120 crosses the placenta
HIV patient (CD4 <100) with low-grade fevers, cough, HSM, tongue ulcer; oval yeast forms within macrophages
Normal CD4 count
Hairy leukoplakia often presents on lateral tongue in HIV+ pt and is associated with
HIV + pt w/ superficial vascular proliferation in which biopsy reveals NEUTROPHILIC inflammation
Bartonella henselae (bacillary angiomatosis)
HIV+ pt (CD<200) with chronic watery diarrhea; acid-fast cysts in stool
Many ring enhancing lesions in brain of HIV+ pt (CD4<100)
Encephalopathy due to reactivation of latent virus in HIV+ pt (CD4< 200); results in demyelination
JC virus (causes PML)
HIV+ pt w/ meningitis
HIV+ pt with retinitis
HIV + pt w/ superficial vascular proliferation in which biopsy reveals LYMPHOCYTIC inflammation
HHV8 - Kaposi sarcoma
HIV+ pt w/ interstitial pneumonia; biopsy reveals cells with intranuclear inclusion bodies
HIV+ pt w/ pleuritic pain, hemoptysis, infiltrates on imaging
HIV+ pt w/ pneumonia w/ ground glass appearance on imaging
Pneumonia when CD4 count > 200
HIV pt w/ TB like disease, except that it grows well at 41C
Mycobacterium avium-intracellulare (MAC), prophylaxis is azithromycin
Inhibits influenza neuraminidase --> decreased RELEASE of progeny visions; used for treatment and prevention of influenza A + B
Inhibits synthesis of guanine nucleotides by competitively inhibiting inosine monophosphate dehydrogenase;
inhibits guanine synthesis by inhibiting IMP DH
RSV, chronic HCV
hemolytic anemia, severe teratogen
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)
Best drug for HSV
Best drug for VZV
obstructive crystalline nephropathy and acute RF if not adequately hydrated
Mutated viral thymidine kinase
5' monophosphate formed by a CMV viral kinase. Guanosine analog. Triphosphate formed by cellular kinases. Preferentially inhibits viral DNAP
Best drug for CMV
leukopenia, neuropenia, thrombocytopenia, renal toxicity
Mutated CMVP or lack of viral kinase
Drug for acyclovir resistant HSV and ganciclovir resistant CMV retinitis (immunocompromised patient)
Viral DNAP inhibitor that binds to the pyrophophate-binding site of the enzyme. DOES NOT REQUIRE ACTIVATION BY A VIRAL KINASE
mutated DNA polymerase
Viral DNAP inhibitor that does not require phosphorylation by viral kinase.
CMV retinitis in immunocompromise; acyclovir-resistant HSV
Nephrotoxicity (coadminister w/ probenecid and IV saline)
Which protease inhibitor can booth other drug concentrations by inhibiting cyctochrome P450?
Protease inhibitor SE
Hyperglycemia, GI intolerance, lipodystrophy
What protease inhibitor additionally has the side effects of nephrotoxicity and hematuria?
What NRTI does not need to phosphorylated to be active?
What is the prototypical NRTI that is used general prophylaxis and during pregnancy to decrease the risk of fetal transmission?
bone marrow suppression (can be reversed with G-CSF and epo), peripheral neuropathy, lactic acidosis (nucleosides), anemia (ZDV), pancreatitis (didanosine)
bind to reverse transciptase at site different from NRTI. Do not require phosphorylation to be active or compete with nucleotides.
rash and hepatotoxicity
Vivid dreams, CNS sympatoms
NNRTIs that are c/i in pregnancy
Inhibits HIV genome integration by reversibly inhibiting HIV integrase
Glycoproteins normally synthesized by virus-infected cells, exhibiting a wide range of antiviral and anti tumor properties
HBV + HCV