Antivirals Flashcards Preview

Pharmacology > Antivirals > Flashcards

Flashcards in Antivirals Deck (45):
1

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.

2

Herpes DOC

Acyclovir

3

Acyclovir resistance

decrease viral thymidine kinase so the drug can't be activated by phosphorylation.

4

Acyclovir kinetics

oral/IV/topical. Short half life. Concentrated (trapped) in viral cells. Excreted by the kidney

5

Valcyclovir

pro-drug with higher bioavailability. Eventually converted into acyclovir.

6

Acyclovir uses

genital herpes, oral herpes, herpes keratitis, encephalitis, prophylaxis in organ transplants.

7

Acyclovir toxicity

nephrotoxicity with high IV doses (decreased with hydration), nausea/vomiting, HA. Safe to use during pregnancy.

8

Docosanol (Abreva) MOA

Inhibits viral fusion

9

Docosanol (abreva) uses

OTC topical preparation for cold sores

10

Ganciclovir/valganciclovier MOA

Guanosine analogue activated by viral kinases. inhibits DNA polymerase. Less active and more toxic than Acyclovir.

11

Ganciclovir kinetics

Ocular implant, IV, Oral.

12

valganciclovir kinetics

Oral prodrug.

13

Ganciclovir uses

CMV/Herpes in immunocompromised, CMV retinitis, Life threatening CMV infections.

14

Ganciclovir toxicity

myelosuppression (neutro, thrombo, leuko) especially when used with zidovudine for HIV. Severe HA, confusion and seizures.

15

Foscarnet (foscvir) MOA

directly inhibits DNA/RNA polymerase and reverse transcriptase. No need for phosphorylation (good for use in resistant strains).

16

Foscarnet uses

Back up for HSV/CMV that are resistant to acyclovir or ganciclovir.

17

Foscarnet toxicity

Renal, adjust the dose and hydration.

18

Cidofovir (vistide) MOA

Cytosine analogue that inhibits viral DNA polymerase. Phosphorylated independent of viral enzymes.

19

Cidofovir uses

Back up for resistant strains of CMV and HSV.

20

Cidofovir toxicity

Dose dependent nephrotoxicity (hydration).

21

Osteltamivir (tamiflu)/Zanamivier (Relenza) MOA

Neuraminidase inhibitor. Blocks the release of the virus from the host cell.

22

Osteltamivir (tamiflu)/Zanamivier (Relenza) uses

Active against influenza A and B. Has to be used within 48 hours of symptom onset.

23

Osteltamivir (tamiflu) administration

Oral. approved for >1 year of age. Also used for the bird flu.

24

Osteltamivir (tamiflu) toxicity

nausea and vomiting (take with food)

25

Zanamivier (Relenza) administration

nasal/oral inhaler. approved for >7 years of age.

26

Zanamivier (Relenza) toxicity

Worsens COPD and asthma. Shouldn't be given if patient has any airway disease.

27

Amantadine (symmetrel)/Rimantadine (flumadine) MOA

inhibits viral uncoating

28

Amantadine (symmetrel)/Rimantadine (flumadine) uses

prophylactic or symptomatic treatment of influenza A. Rarely used due to rapid development of resistance.

29

Ribavirin (virazole) MOA

Guanosine analogue that inhibits RNA polymerase and synthesis of GTP. Independent of viral kinases for phosphorylation.

30

Ribavirin (virazole) toxicity

hemolytic anemia, respiratory depression, cardiac arrest, IV use cause psychiatric issues. TERATOGENIC! even with occupational exposure.

31

RSV DOC

Ribavirin (virazole)

32

Ribavirin (virazole) uses

DOC for RSV. Also used to treat HCV along with interferon.

33

Interferon-alpha2b (intron-A) MOA

Blocks EVERYTHING (entry, transcription, translation, replication, processing, assembly and release). Given IV/IM.

34

PEG-interferon

Interferon-alpha2b (intron-A) that is long lasting and given as a depot prep once a week.

35

Interferon-alpha2b (intron-A) uses

HCV with ribavirin and chronic HBV.

36

Interferon-alpha2b (intron-A) toxicity

Flu-like symptoms, CNS depression and suicide (MUST prescrive with an antidepressant), hematologic, cardiac (hypotension and edema).

37

Boceprevir (victrelis) MOA

Blocks serine proteases needed for replication of HCV.

38

Boceprevir (victrelis) uses

Oral. Can be added to interferon and ribavirin to treat HCV.

39

Boceprevir (victrelis) toxicity

ihibitor of CYP3A4, exacerbates anemia, neutropenia and fatigue associated with interferon/ribavirin treatment.

40

HBV DOC

Lamivudine.

41

Lamivudine MOA

inhibits HBV polymerase (reverse transcriptase inhibitor)

42

Lamivudine use

DOC for chronic HBV can also treat HIV. Oral. few side effects.

43

Adefovir MOA

inhibits HBV DNA polymerase.

44

Adefovir toxicity

renal toxicity

45

Entecavir MOA

Guanosine analogue. Inhibits HBV DNA polymerase.