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Antivirals Flashcards

(57 cards)

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1
Q

HSV1

A 
Mouth/face
Skin
Esophagus
Brain
Lungs (pneumonia uncommon)
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2
Q

HSV2

A 
Genitals
Rectum
Skin
Hands
Meninges
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3
Q

HSV3

A

Varicella Zoster (VSV)
Chicken pox
Shingles
Pneumonia

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4
Q

HSV4

A

Epstein-Barr (EBV)

Mononucleosis

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5
Q

HSV5

A

Cytomegalovirus (CMV)
Systemic hematopoietic disorders
Interstitial pneumonia

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6
Q

Acyclovir - Target

A

HSV2 - mainly

HSV3

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7
Q

Acyclovir - MOA

A

Guanosine Analog

Needs viral thymadine kinase

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8
Q

Acyclovir - Resistance

A

Altered/deficient thymadine kinase

Altered DNA polymerase

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9
Q

Acyclovir - PK

A

IV administered
Distributes to well (inc. CSF)
Renally cleared

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10
Q

Valcyclovir

A

Same as acyclyovir but PO prodrug

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11
Q

Acyclovir - ADR

A 
Nephrotoxicity - can be avoided with hydration
N/V/D
Neurotoxicity - Siezure, tremor, CNS
Hematologic toxicity - Thrombocytopenia
Irritation if applied topically
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12
Q

Ganciclovir - Target

A

HSV5 Mainly
HSV2
HSV3
Used as prophylaxis in transplant patients

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13
Q

Ganciclovir - MOA

A

Guanosine Analog - same as acyclovir

Requires Viral thymadine kinase

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14
Q

Valganciclovir

A

Oral prodrug of Ganciclovir

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15
Q

Ganciclovir - PK

A

IV Administered

Renally cleared

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16
Q

Ganciclovir - ADR

A 
Myelosuppression
Thrombocytopenia
Neurotoxicity
N/V/D
Phlebitis
Fever
Carcinogenic/Teratogenic
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17
Q

Penciclovir - Target

A

HSV1
HSV2
HSV3

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18
Q

Penciclovir - MOA

A

Does not terminate DNA chain
Guanosine analog
Requires Viral thymadine kinase

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19
Q

Penciclovir - PK

A

Topically administered
Long half life (7-20 hours)
Renally cleared

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20
Q

Penciclovir - ADR

A

N/V/D
CNS effects
Rash/Hives
May be carcinogenic

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21
Q

Penciclovir - Resistance

A

Deficient/mutated thymadine kinase

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22
Q

Famcyclovir

A

PO prodrug of Penciclovir

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23
Q

Cidofivir - Target

Study These Flashcards
A

HSV5
In vitro activity against other HSVs
Experimental against adenovirus

24
Q

Cidofivir - MOA

Study These Flashcards
A

Cytosine Anolog

Does not require viral activation

25
Cidofivir - Resistance
Drugs resistant to this class tend towards resistant to all analogs
26
Cidofivir - PK
Parent drug has active metabolites Poorly understood Poor CSF distro Renally excreted
27
Cidofivir - ADR
Nephrotoxicity - significant (can be counteracted with dilution or probenicid) Neutropeniua Metabolic acidosis Mutagenic, gonadotoxic, embryotoxic
28
Foscarnet - Target
Resistant HSV (esp. Cidofivir resistant HSV5)
29
Foscarnet - MOA
Pyrophosphate derivative Inhibits DNA elongation Blocks pyrophosphate binding site Does not require activation
30
Foscarnet - Resistance
Mutated viral DNA polymerase
31
Foscarnet - PK
IV administered Distributes well (+CSF) Deposits in bone Renally cleared
32
Foscarnet - ADR
``` Nephrotoxicity Electrolyte imbalance (Ca++, Mg+, K+, Po) Anemia N/V/D CNS effects (rare) ```
33
Amantadine - Target
Influenza A
34
Rimantidine - Target
Influenza A
35
Amantadine & Rimantidine - MOA
Block viral M2 H+ channel | Prevents release from endosome
36
Amantadine & Rimantidine - Resistance
Common within first few days
37
Amantadine & Rimantidine - PK
``` Orally dosed with good availability Renally cleared (Amantadine) Hepatically metabolized (Rimantidine) ```
38
Amantadine & Rimantidine - ADR
CNS effects - exacerbate previous seizure d/o | N/V/D
39
Amantadine - DDI
Antihistamies Psychotropics Anticholinergics ALL increase neurotoxicity
40
Oseltamivir - Target
Influenza A Influenza B RSV
41
Zanamivir - Target
Influenza A Influenza B RSV
42
Peramivir - Target
Influenza A Influenza B RSV
43
Oseltamivir, Zanamivir, Permivir - MOA
Neuraminidase Inhibitor
44
Oseltamivir, Zanamivir, Permivir - PK
Oral (Oseltamivir) - Prodrug IV (Peramivir) Inhaled (Zanamivir) Renally excreted
45
Oseltamivir, Zanamivir, Permivir - ADR
``` N/V/D Respiratory irritation (Zanamivir) ```
46
Oseltamivir, Zanamivir, Permivir - Resistance
Mutations to neuraminidase - usually less infective than WT
47
Baloxivir Marboxil - Target
Influenza A | Influenza B
48
Baloxivir Marboxil - MOA
CAP endonuclease inhibitor
49
Baloxivir Marboxil - ADR
HA N/V/D Liver Enzyme elevation
50
Ribavarin - Target
Broad spectrum | RSV mainly
51
Ribavarin - MOA
Guanosine analog Not well characterized Virally activated Inhibits viral replication
52
Ribavarin - PK
PO or inhaled Aerosol in young children with RSV Renally cleared
53
Ribavarin - ADR
``` Hemolytic anemia (can be severe) Monitor aerosol for respiratory function Teratogenic ```
54
Palvizumab - Target
RSV ONLY IN HIGH RISK PEDS Prophylactic
55
Palvizumab - MOA
Blocks RSV F protein from binding to host
56
Palvizumab - PK
IM | Metabolized through CYP450
57
Palvizumab - ADR
Hypersensitivity Thrombocytopenia Fever Rash

Pharmacology (6 decks)

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