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Pharm 4 > Antivirals > Flashcards

Antivirals Flashcards

(65 cards)

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1
Q

NRTI’s

A

Abacavir, Lamivudine, Emtricitibine

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2
Q

NNRTI’s

A

Efavirenz

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3
Q

Nucleotide

A

Tenofovir

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4
Q

HIV Protease inhibitors

A

Ritonavir, Darunavir, Atazanavir

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5
Q

Fusion/Entry/Integration inhibitors

A

Enfuvirtide, Maraviroc, Dolutegravir

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6
Q

Genotype for resistance?

A

RT and Protease

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7
Q

Zidovudine (AZT) - analog

A

Thymidine

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8
Q

NRTI’s - TOX

A

mitochondrial DNA polymerase gamma TOX
Hyperlipidemia/insulin resistance (aidovudine, stavudine)
Lactic acidosis with hepatic steatosis (life threatening, monitor aminotransferase levels)

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9
Q

Abacavir - analog

A

Guanosine

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10
Q

Abacavir - metabolism

A

Deactivated in liver

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11
Q

Abacavir - combo

A

+Lamivudine

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12
Q

Abacavir - TOX

A

MI (caution in CV, platelet adhesion)
HLA-B*5701 hypersensitivty
skin rash

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13
Q

Lamivudine/Emtricitabine - analog

A

L = cytosine analog (Em is fluorinated analog of L, longer half life)

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14
Q

Lamivudine/Emtricitabine - used in?

A

HBV treatment

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15
Q

Truvada

A

Emtricitabine + Tenofovir DF

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16
Q

Tenofovir - analog

A

acyclic nucleotide of adenosine

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17
Q

Tenofovir - drug or prodrug?

A

Prodrug

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18
Q

Truvada - use?

A

First line backbone + chronic hepatitis

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19
Q

Truvada - excrete?

A

Renal

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20
Q

Truvada - TOX

A 
fatigue
weakness
flatulence
renal accumulation (ATN, renal failure, Fanconi's)
osteopenia
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21
Q

Efavirenz - mechanism

A

Allosteric binding to RT, inhibits RNA/DNA polymerase, doesn’t need phosphorylation, not competitive inhibition, not against HIV-2

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22
Q

Efavirenz - in pregnancy?

A

NO

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23
Q

Which HIV drug NOT in pregnancy?

A

Efavirenz

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24
Q

Efavirenz - drug drug rx

A

metabolized by/induces CYP3A4

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25
Efavirenz - TOX
nightmares/psych (at start - resolves) | GI, skin, SJS
26
Protease inhibitors - mechanism
peptidomimetics, inhibit proteolytic cleavage of gag and gag-pol, no activation, resistsance common
27
Protease inhibitors - metabolism
metabolized by and inhibits CYP3A4
28
Protease inhibitors - TOX
lipodystrophy, increased triglycerides + LDL
29
Ritonavir - administration
+food - incr bioavailability | + other PT - boosted
30
Ritonavir - metabolism
inhibits CYP3A4
31
Ritonavir - TOX
incr triglycerides + LDL + aminotransferase
32
Lopinavir - combo?
only with Ritonavir (R inhibs CYP3A4 - incr Lopinavir)
33
Lopinavir - metabolism
hepatic clearance
34
Lopinavir - in pregnancy
YES
35
Maraviroc - mechanism
inhibits gp120 binding | binds selectively to CCR (1/2)
36
Maraviroc - TOX
Hepatic block box
37
Enfuvirtide - mechanism
binds to gp41
38
Enfuvirtide - administration
sub Q
39
Enfuvirtide - caution
only in tx experienced pts
40
Dolutegravir - mechanism
inhibits integration (INSTI)
41
PEP
Raltegravir + Tenofovir DF + Emtricitabine
42
PrEP
Tenofovir DF + Emtricitabine
43
Acyclovir - analog
Guanosine analog
44
Acyclovir - mechanism
viral thymidine kinase - 1st phosphate | competes with deoxyGTP
45
Acyclovir - target
1st line: HSV encephalitis, neonatal HSV, severe HSV/VZV HSV1/2 >>VZV EBV, CMV, HHV-6
46
Acyclovir - uses
topical, IV, goes to CSF
47
Acyclovir - clearance
Renal
48
Acyclovir - TOX
N/V, HA, renal tox (crystals IV), neurotox (tremor, delirium, seizures) increase fluids
49
Acyclovir - drug drug rx
Probenecid/cimetidine increase acyclovir
50
Acyclovir - resistance
reversible, TK mutation (use Foscarnet)
51
Ganciclovir - analog
acyclic guanosine analog
52
Ganciclovir - target
CMV (HSV, VZV, HHV 6/8) | post-transplant
53
Ganciclovir - administration
IV, intraocular
54
Gancyclovir - TOX
myelosuppresssion, carcinogenic?
55
Foscarnet - analog
pyrophosphate analog
56
Foscarnet - mechanism
inhibits DNA/RNA polymerase
57
Foscarnet - administration
IV only
58
Foscarnet - use
good for acyclovir resistance
59
Foscarnet - TOX
renal, hyperphosphatemia, hypokalemia/calcemia/magnesemia
60
Oseltamivir / Zanamivir - administration
PO / inhalation
61
Oseltamivir / Zanamivir - mechanism
neuraminidase inhibitors, don't let progeny out
62
Oseltamivir / Zanamivir - analog
sialic acid analog
63
Oseltamivir - metabolism
Requires hepatic activation
64
Oseltamivir / Zanamivir -ages
O > 1yr, Z > 7 yrs
65
Amantadine - mechanism
NMDA antag (anti-Park), inhibits uncoating

Pharm 4 (5 decks)

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