Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Antivirals/retrovirals > Flashcards

Antivirals/retrovirals Flashcards

1
Q

Purine/pyrimidine Analog which is the

DOF IN: HSV ENCEPHALITIS

A

ACYCLOVIR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Neuraminidase Inhibitors. Name them:

A

Oseltamivir, Zanamivir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Synthetic Guanosine analogue that is:

  • Active against broad spectrum of RNA & DNA viruses (eg, RSV, HCV, Lassa fever)
  • Commonly used in combination with interferon for the treatment of HCV

name the Antiviral

A

Ribavirin

Purine/pyrimidine Analogs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

which drug is commonly used in combination with interferon for the treatment of HCV?

A

ribavirin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

if you attempt to treat HBV or HIV (hepatic infections) with Lamivudine but have no luck what is drug you can use that you can use? pick one.

Interferon

Ganciclovir

Ribavarin

Entecavir

Cidofovir

A

Entecavir

(must monitor after discontinuation in case of exacerbation of severe hepatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

whats the most common AE related to the Fusion inhibitor Enfuvirtide

A

Injection site-related rxs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

The herpes antiviral drug which does NOT require phosphorylation to be active is indicated in the treatment of… name 3 things

What is the drug?

A

CMV

CMV retinitis (in immunocompromised patients)

Acyclovir-resistant HSV & CMV retinitis

Ganciclovir-resistant CMV & VZV

The drug is Foscarnet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

list all the NRTI’s

ST. Z’ LEAD

A

Stavudine

Tenofovir

Zidovudine

Lamivudine

Emtricitabine

Abacavir

Didanosine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Herpes Simplex Labialis (cold sores) is treated with this drug and the AE associated with it is Mild erythema.

A

Penciclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

which herpes antiviral DOES NOT require phosphylation to be active?

A

Foscarnet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Are protease inhibitors metabolized by CYP3A4 and P glycoprotein?

A

yes, extensively.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

which antiviral….

prevents viral mRNA capping.

used to treat

  • *1. RSV
    2. HCV**

3.LASSA FEVER

A

Ribavirin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

List the 5 Protease Inhibitors (PIs)

L’ D I N A

A

Lopinavir

Darunavir

Indinavir

Nelfinavir

Atazanavir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

which vacciens are CI in pts with a CD4+ count of < 200?

A

LIVE VACCINES!

  • MMR
  • Varicella and • Zoster

Other vaccines may be administered without regard to the patient’s CD4+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

which is the only ONCE daily PI’s

A

Atazanavir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Blocks viral membrane protein, M2 (H+ ion channel)

• Channel is required for fusion of viral with cell membrane to endosome (requirement for viral uncoating)

which drug is this?

A

the -tadines!

Amantadine

Rimantadine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

name the antiviral with the following pattern of pharmodynamics & AE

  • Oral, IV, & aerosolized
  • Distribution significantly prolonged in RBC (16-40 days)

Adverse Effects

• Dose-dependent transient anemia (can bind to RBC)

A

Ribavirin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q
  • GI discomfort, nausea (alleviated when taken with food)
  • airway irritation (avoid in severe asthma, COPD)

match the drug with the AE of the following Neuramidase inhibitors.

options are: Oseltamivir & Zanamivir

A
  • GI discomfort, nausea (alleviated when taken with food)=Oseltamivir
  • airway irritation (avoid in severe asthma, COPD)=Zanamivir (side note, the med is inhaled/intranasal and is NOT orally active)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Upon exposure to HIV, healthcare personnel should immediately receive a postexposure prophylaxis regimen containing at least 3 antiretroviral drugs. what are the preffered 3 drugs in this regiment

A

Raltegravir (INSTI) + tenofovir (NRTI) + emtricitabine (NRTI)

Regimen is given for 28 days and can be stopped if source is shown to be HIV-negative.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Do NNRTI’s have in vitro activity against HIV 2?

A

NO.

from SGD.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

the absorption of which protease inhibitor decreaes if take with a meal

A

INDINAVIR

main AE: hematuria, Rash, blurred vision, nephrolithiasis & hyperbilirubinemia

23
Q

which class of drugs is being described? • Currently most popular antiretroviral class due to good side-effect profile and favorable effects on lipid metabolism

A

INSTI’s (integrease inhibitors)

24
Q

Name that NNRTI

AE list: Rash, dizziness, headache, insomnia, difficulty concentrating, vivid dreams, nightmares, reductions in vitamin D levels, hyperlipidemia,

teratogenic (avoid in 1st trimester)

Substrate of CYP3A4

Inducer of CYP3A4 and 2B6

A

Efavirenz

25
Q

Transient eye irritation, light intolerance & palpebral (eyelid) edema are the main AE for which Anti Herpes anti-viral?

A

Trifluridine (its an opthalmic ointment)

DOC for HSV Keratoconjunctivitis

26
Q

does Acyclovir or Valacyclovir (its prodrug) have greater ORAL bioavailbility?

A

Valacyclovir

Val gives better ORAL.

27
Q

What is an important toxicity common to all approved protease inhibitors?

A

the potential for metabolic drug interactions. Most of these drugs inhibit CYP3A4

28
Q
  • Effective against hepatitis B and HIV
  • Triphosphate form inhibits HBV and HIV reverse

transcriptase

  • Monophosphate form is incorporated into DNA (by HBV polymerase) resulting in chain termination
  • Well tolerated (headache, dizziness, GI complaints)
A

Lamivudine

29
Q

all Herpes antivirals Require phosphorylation by viral kinases and work by Inhibiting DNA polymerase /DNA synthesis. which is the only one that is phosphorylated by host cellular kinases only?

A

Cidofovir (does not require any viral enzymes)

30
Q

Resistance to drug is acquired by Mutations in phosphotranferase (UL97), or viral DNA polymerase AND its the

DOC for: CMV retinitis & CMV prophylaxis in

immunocompromised

A

Ganciclovir

31
Q

which NNRTI is CI in the first trimester if pregnancy

A

Efavirenz

32
Q

The following class of antiretrovirals has the following AE:

hyperglycemia, insulin resistance and hyperlipidemia, in addition to altered body fat distribution. Buffalo hump, gynecomastia, and truncal obesity may occur with facial and peripheral lipodystrophy. They are also associated with parathesias, nausea, vomiting and diarrhea.

A

Protease Inhibitors

33
Q

which Integrase inhibitor has the following drug interactions

Drug Interactions
• Rifampin, tipranavir & efavirenz may decrease its conc

• PPI’s may increases it conc

A

raltegraivr

side note. Can cause increases in creatine phosphokinases

34
Q

What do Efavirenz and Nevirapine share in common in relation to the CYP P 450 system

A

Inducer of CYP3A4 and 2B6

35
Q

Lets say an adult pt has Hep C, and you’ve tried interferon and ribavirin but no luck there. whats an alternative?

A

The -previrs!

Boceprevir, Telaprevir (Protease Inhibitors)

36
Q

due to its poor intrinsic bioavailability, WHICH Protease inhibitor requires the avoidance of Enzyme inducers such as St. Johns worts andn Rifampin

this is a PREFFERED PI by the way

A

LOPINAVIR

37
Q

which class of antiretrovirals is being being described

are more susceptible to high-level drug resistance than other classes because a single-amino acid change in the NNRTI-binding pocket renders the virus resistant to all available drugs in the class and this is their major disadvantage.

A

The NNRTIs

38
Q

• ___________ form inhibits HBV and HIV reverse

transcriptase

• ___________form is incorporated into DNA (by HBV polymerase) resulting in chain termination

fill in the blank with with either “Monophosphate” or Triphosphate” in relation to which type of Lamivudine mechanism is being described.

A

• Triphosphate form inhibits HBV and HIV reverse

transcriptase

• Monophosphate form is incorporated into DNA (by HBV polymerase) resulting in chain termination

39
Q

Prevents viral mRNA capping inhibition of RNA polymerase

Teratogenic (Cat X)

can bind to RBC and therefore causes transient dose dependent anemia

A

Ribavirin (guanosine analogue)

40
Q

Do Amantadine or Rimantadine fit the following description?

  • ________is widely distributed & crosses BBB and is not extensively metabolized & excreted into urine where it may accumulate
  • ________ IS metabolized before elimination in urine
A

Amantadine (first blank)

Rimantadine (second blank)

41
Q

• Major use is treatment of CMV-induced retinitis in HIV/AIDS

  • NOT phosphorylated by viral kinases
  • Requires activation by host cell kinases (no viral enzymes necessary!)
A

CIDOFOVIR

42
Q

Name that NNRTI

Rash, fever, nausea, headache, severe hepatotoxicity, hepatic failure and death

Inducer of CYP3A4 and 2B6

A

Nevirapine

43
Q

The following MOA belongs to which class or ANTIRETROVIRALS

competitively inhibit the action of the virus aspartyl protease. These drugs prevent proteolytic cleavage of HIV gag and pol polyproteins that include essential structural and enzymatic (reverse transcriptase, protease and integrase) components of the virus. This prevents the metamorphosis of HIV particles into their mature infectious form.

OVERALL, THEY PREVENT PROCESSING OF VIRAL PROTEINS, RESULTING IN THE PRODUCTION OF IMMATURE NON INFECTIOUS VIRAL PARTICLES

A

HIV protease inhibitors

Lopinavir

Darunavir

Indinavir

Nelfinavir

Atazanavir

44
Q

Which purine/pyrimidine analogue (which is a Pyrophosphate analogue) does NOOOOTTTTTTT require phosphorylation?

A

FOSCARNET

45
Q

which PI CANNOT be boosted by Ritonavir bc its metabolized by several CYPS and it also has a ton of CI’s and Generally well tolerated, diarrhea, nausea and flatulence are common

A

Nelfinavir

46
Q
  • Effective against HSV & ganciclovir resistant HSV
  • Must be co-administered with probenecid (blocks renal tubular secretion)

name that drug.

A

CIDOFOVIR

47
Q

which of the following are AE/CI are associated with Ganciclovir

a. Myelosuppressionb.

b. insomnia, dizziness, ataxia leading to hallucinations, seizures]
c. Severe dose-dependent neutropenia

d. Pregnancy (FDA Category C)
e. Flu-like (fever, chills, myalgias & GI disturbances)
f. Fatigue & mental depression

A

a. Myelosuppression​

c. Severe dose-dependent neutropenia

d. Pregnancy (FDA Category C)

48
Q

Zidovudine (thymdidne analogue) is an NRTI whose main AE is Bone suppression in pts with advnaced HIV diseae). When combined with_______ (antiviral), pt could get Neutropenia

A

Ganciclovir

49
Q
  • Used in combination with most protease inhibitors (not nelfinavir)
  • Never used alone

____________________________________

  • Used commonly in combination with the INSTI elvitegravir
  • Also found in combination with darunavir and atazanavir (which are both PI’s)
A
  1. RITONAVIR
  2. COBICISTAT
50
Q

Guanosine analogs.

Monophosphorylated by HSV/VZV thymidine kinase and not phosphorylated in uninfected cells

A

ACYCLOVIR

51
Q

the following MOA is associated with which antiviral drug?

MOA

  • Use innate immune response.
  • DO NOT target viral gene products directly
  • Inhibit RNA & DNA synthesis by activating / inducing protein expression that inhibit virus infection eg, PKR
A

Interferon

52
Q

a. Neuraminidase Inhibitors [for Influenza A & B]

b. Inhibitors of Viral Uncoating [for Influenza A ONLY!!!]

c. Synthetic Guanosine Analog (inhibits RNA dep-RNA pol)-[for RSV, HCV, Lassa Fever]

  • Amantadine, Rimantadine
  • Ribavirin
  • Oseltamivir, Zanamivir

match the desciption with the name of the dru

A

a. Neuraminidase Inhibitors [for Influenza A & B]

• Oseltamivir, Zanamivir

b. Inhibitors of Viral Uncoating [for Influenza A ONLY!!!]

• Amantadine, Rimantadine

c. Synthetic Guanosine Analog (inhibits RNA dep-RNA pol)-[for RSV, HCV, Lassa Fever]

• Ribavirin

53
Q

List the 3 Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs)

A

Nevirapine

Efavirenz

Rilpivirine

Pharmacology (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions