Flashcards in Antivirals Deck (45):
Acyclovir (zovirax) MOA
Guanosine analogue.Inhibits DNA synthesis by competing with dGTP. Terminates the chain due to lack of 3 prime hydroxyl. Requires phosphorylation by viral thymidine kinase.
decrease viral thymidine kinase so the drug can't be activated by phosphorylation.
oral/IV/topical. Short half life. Concentrated (trapped) in viral cells. Excreted by the kidney
pro-drug with higher bioavailability. Eventually converted into acyclovir.
genital herpes, oral herpes, herpes keratitis, encephalitis, prophylaxis in organ transplants.
nephrotoxicity with high IV doses (decreased with hydration), nausea/vomiting, HA. Safe to use during pregnancy.
Docosanol (Abreva) MOA
Inhibits viral fusion
Docosanol (abreva) uses
OTC topical preparation for cold sores
Guanosine analogue activated by viral kinases. inhibits DNA polymerase. Less active and more toxic than Acyclovir.
Ocular implant, IV, Oral.
CMV/Herpes in immunocompromised, CMV retinitis, Life threatening CMV infections.
myelosuppression (neutro, thrombo, leuko) especially when used with zidovudine for HIV. Severe HA, confusion and seizures.
Foscarnet (foscvir) MOA
directly inhibits DNA/RNA polymerase and reverse transcriptase. No need for phosphorylation (good for use in resistant strains).
Back up for HSV/CMV that are resistant to acyclovir or ganciclovir.
Renal, adjust the dose and hydration.
Cidofovir (vistide) MOA
Cytosine analogue that inhibits viral DNA polymerase. Phosphorylated independent of viral enzymes.
Back up for resistant strains of CMV and HSV.
Dose dependent nephrotoxicity (hydration).
Osteltamivir (tamiflu)/Zanamivier (Relenza) MOA
Neuraminidase inhibitor. Blocks the release of the virus from the host cell.
Osteltamivir (tamiflu)/Zanamivier (Relenza) uses
Active against influenza A and B. Has to be used within 48 hours of symptom onset.
Osteltamivir (tamiflu) administration
Oral. approved for >1 year of age. Also used for the bird flu.
Osteltamivir (tamiflu) toxicity
nausea and vomiting (take with food)
Zanamivier (Relenza) administration
nasal/oral inhaler. approved for >7 years of age.
Zanamivier (Relenza) toxicity
Worsens COPD and asthma. Shouldn't be given if patient has any airway disease.
Amantadine (symmetrel)/Rimantadine (flumadine) MOA
inhibits viral uncoating
Amantadine (symmetrel)/Rimantadine (flumadine) uses
prophylactic or symptomatic treatment of influenza A. Rarely used due to rapid development of resistance.
Ribavirin (virazole) MOA
Guanosine analogue that inhibits RNA polymerase and synthesis of GTP. Independent of viral kinases for phosphorylation.
Ribavirin (virazole) toxicity
hemolytic anemia, respiratory depression, cardiac arrest, IV use cause psychiatric issues. TERATOGENIC! even with occupational exposure.
Ribavirin (virazole) uses
DOC for RSV. Also used to treat HCV along with interferon.
Interferon-alpha2b (intron-A) MOA
Blocks EVERYTHING (entry, transcription, translation, replication, processing, assembly and release). Given IV/IM.
Interferon-alpha2b (intron-A) that is long lasting and given as a depot prep once a week.
Interferon-alpha2b (intron-A) uses
HCV with ribavirin and chronic HBV.
Interferon-alpha2b (intron-A) toxicity
Flu-like symptoms, CNS depression and suicide (MUST prescrive with an antidepressant), hematologic, cardiac (hypotension and edema).
Boceprevir (victrelis) MOA
Blocks serine proteases needed for replication of HCV.
Boceprevir (victrelis) uses
Oral. Can be added to interferon and ribavirin to treat HCV.
Boceprevir (victrelis) toxicity
ihibitor of CYP3A4, exacerbates anemia, neutropenia and fatigue associated with interferon/ribavirin treatment.
inhibits HBV polymerase (reverse transcriptase inhibitor)
DOC for chronic HBV can also treat HIV. Oral. few side effects.
inhibits HBV DNA polymerase.