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Antivirals Flashcards

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1
Q

What are some of the main differences between antivirals and antibiotics?

A

Many are virostatic compared to virocidial, rarley given empirically, few virsus have specific drugs and tend to be fewer broad specturms

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2
Q

Describe some of the agents that directly inactivate viruses?

A

Non organic detergants and chlorine based solvents, organic solvents such as ether alcohol and chlorform, and cyrothearpy can be used for removal or lesions

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3
Q

What are the stages of viral replication?

A

Attachement, uncoating, rna and dna replication, assembly, and realease

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4
Q

What is the role of immunomodulators as antivirals?

A

Can be used to replace deficient host cell immunity, or enhance host cell immunity

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5
Q

Name some of the antivirals that act against the herpes virus

A

Aciclovir, ganvlilovir, cidofovir, Foscarnet

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6
Q

What is the mechanism of action of aciclovir?

A

Phosphorylated by thidimine kindase, and is used as a substrate for viral rna polymerase

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7
Q

What are some of the adverse effects of aciclovir?

A

Headache, nuasea, diarrhea, nephrotocisity

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8
Q

What are some of the other uses for aciclovir?

A

Can be given empirically before a bone marrow transplant

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9
Q

What is the mechansim of building resistance to aciclovir

A

Altered or deficent thiamine kinase

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10
Q

What is the mechanism of action of gan iclovir

A

Activated by conversion to nucleoside triphospate by viral and cellular enzymes, and this inhbits DNA polymerase, and incoperated into DNA resulting in chain termination

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11
Q

What are some of benefits of gancilovir compared to aciclovir?

A

Is ana anolgue that has greater action agaisnt CMV

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12
Q

What are some of the adrs of gancilclovir?

A

Carcinogenic, embroyotcis, and can cause severe dose dependant neutropenia

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13
Q

What is cidofivor used for?

A

The treatment of cytomegalovirsus in paitetns with aids

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14
Q

What is the mechanism of action of cidofovir?

A

A nucleoside analogue of cysteine, and phosphorylation is not dependant on viral or cellular enzymes and inhibits DNA polymerase and DNA chain elongation

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15
Q

What are some of the adverse effects of cidofovir?

A

Nephortoxic, myelosupperssive, and can cause a neutropenia

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16
Q

What is the mechanism of action fosacarnet?

A

Reversibly and non competively blocks the viral polymerase, and is 100x more effective agaisnt Haib and herpes virsus

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17
Q

What are some of the adverse effects of fosacronet?

A

Has a narrow therapetuic index, nephrotocitcity, tremor and irritability and well as headaches and seziures

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18
Q

What are some of the antivirals that can be used agaisnt hepatitits B
?

A

Telebiuvidine thymidine, entecavir anf lamivudine

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19
Q

What is the mechanism of action of lamivudine?

A

Must be phosphorylated in the cell to an active form, ic a cyctidine nucleotide anlogue and acts as a false substrate and causes chain termination

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20
Q

What are some of the adverse effects of lamivudine?

A

Dizziness, headches, rise in liver enzymes but is usually well tolerated

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21
Q

What is the mechanism of entecavir?

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A

A guanionside nucleotides nucelotide analogue, and is more active than lamivuadine in HBV

22
Q

What is the mechanism of action of telbivudine thymidine?

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A

Is a potent inhibitor of HBv replication, and can be encoperated into viral DNA and stops futher elongation

23
Q

Name a antiviral that can work in hepaitis c?

24
Q

What is the mechanism of action of ribvarin?

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A

A guanoside anaolgue, and reversiblet alters cellular nucleotide stores, and therefore affecte viral RNA and mRNA sythesis

25
What are some of the adverse effects of rivarin?
Can cause anxiety, nuasea and myalgia, cough and can cause reversible anaemia
26
What are some of the antivirals that can be used in respiritory infections?
Adamante antivirals , neuraminase inhibitors,
27
Name adamante antivirals?
Adamtache and riamntadine
28
What is the mechansim of action of adamante antivirals?
Inhbit channel M2 fucntion of the influenza A and B ciarsuses, and preventing the normal pH mediated uncoating, and therefore prevents viral realease
29
How can resistance occur in admante antivirals?
Occurs readily with single AA substutions, and this has little effect on viral fitness
30
What are some of the adrs assoicated with admante antivirals?
Nausea, insoonia confusion, appetite loss, difficulty concentrating, light headness, nervousness, and more serious CNS effects including delirium, hostility, halluncinations, tremor and seizires
31
Name some of the neuraminase inhibitors?
Ostemavir or zanamavir
32
What is the mechanism of action of neuraminase inhibitors?
Influenza virsuses have a specific neuroaminase inserted into the membrane for realeasing virsuses, and therefore by inhbiting these the realease of virsuses into the cell is prevented
33
What are some of the ways that reistance can develop agaisnt neuroaminase inhbitors?
Mutations in the Naa gene, however this produces a less fit virsus
34
What are some of the adrs of neuraminase inhbitors?
Nasuea, vomiting, ado discomfort however they are generally well tolerated
35
What is the mechansim of action of interferons?
Are poorly understood, however are potent cytokines known to have a immunomodulatory effect and could cause the idnuction of host cell enzymes inhbiting viral dna
36
What are the IFNs that are producted by most cells?
IFN A and IFN B
37
What is the class of iFN produced by lymphocytes
IFN y
38
What are some of the adverse effects of using interferons?
Flu like illness, fever, chills, headaches, diarrhea, vomiting and myalagia
39
What are some of the different classes of anti-retroviral drugs that can be used?
NRTIs, NNRTIs, protease inhibtiors, and fusion inhibotrs and newer classes including entry inhbitors and intergrase inhbitors
40
Name some of the NRTIs?
Lamividine, sidovidine, and dianoside and staviudide
41
What is the mechanism of action of NRTIs?
Is taken up by host cells, and is phosphyrlated by cellular nucleoside into active forms, the triphosphat forms and then act as false substrates, as they lack the 3 -OH group for DNA elongation and therefore inhibit the DNA polymerase function
42
What are some of the adverse effects of NRTIs?
Hepatomegaly, hyperlactinameia, and lactic acidosis, steatossi
43
Name some of the NNRTIs
Tetravirdine, efavirdate, nevocarpjne, deloviridne
44
What is the mechanism of NNRTIS?
Are active without futher phophorylation, cause non competive allosteric inhbition of enzyme function and binds and different sites from the NRTIs and can be used syngeristially
45
What are some of the adverse effects of NNRTIs?
Erthryamatous macupolar rash, and causes raised LFTs
46
Name some of the protease inhbitors?
Saquinavit, riganair, infirvit, ampenavir and laoanavir
47
What is the mechanism of avtion of protease inhbitors
Generally prevent the maturation of viral protetins, and leads to non infectous viras, as they are reversible inhbitors of HIV aspdyl protease, and these is the enzyme responsible for viral polypeptide in a number of stuctural enzymes
48
What are some of the adverse effects of protease inhbitors?
May induce or inhbitor cpy450, and alter the heaptic metabolism of other drugs, and cause possible osteoporsis and osteopenia, and chronic use increases hyperlipidemia, new onset DM and hyperglycemia and cholestrol and leads to an increased risk of Mi
49
What are the mechansim of action of fusion inhbitors?
Interferese with attachment and fusion proccesses between HiV go 129 and gp24 and cellular CD4 and CCR5 and CXCR4 receptors
50
When would fusion inhibtors be used?
As salvage thearpy when ohter drugs have failed
51
What are some of the adverse effects of fusion inhbitors
Inducation, pain, erythemai, nodules, cysts and orutis, and you can also get hypersenstivity reactions

Clincical Pharmacology (5 decks)

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