Chapter 37: Viral Infections Flashcards Preview

Pharmacology > Chapter 37: Viral Infections > Flashcards

Flashcards in Chapter 37: Viral Infections Deck (45)
Loading flashcards...
1

Maraviroc MOA

blocks the chemokine receptor CCR5

(CCR5 is what some HIV strains use for attachment and host entry)

2

What is the approved use of Maraviroc?

Used to tx HIV strains that use CCR5

Used in combo with other HIV drugs

3

Which drug blocks HIV attachment and entry by inhibiting gp41 mediated fusion of HIV envelope w/host plasma membrane?

Enfuvirtide (T-20)

4

Enfuvirtide is a peptide that must be administered ___

parenterally with twice daily injections

5

Which drug blocks the M2 proton channel of influenza virus A and can also be used to treat Parkinson disease? (thus blocks uncoating)

Amantadine

6

Which drug - amantadine or rimantadine - has fewer adverse effects? What are these adverse effects?

Rimantadine has less

Neuroleptic malignant syndrome; exacerbation of mental disorders

7

Which drugs are most commonly used to treat influenza A - inhibitors of viral uncoating or neuraminidase inhibitors?

neuraminidase inhibitors

8

Acyclovir MOA?

monophosphorylated by viral kinases (thmidine kinase), which leads to inhibition of DNA synthesis in virus-infected cells by inhibiting DNA polymerase

9

Drug of choice for HSV or VZV?

Acyclovir

10

What is the prodrug of acyclovir that has a greater oral bioavailability?

valacyclovir

11

How do you develop acyclovir resistance?

mutation in viral thymidine kinase

12

Famciclovir use?

HSV infections and shingles (VZV reinfection)

13

Penciclovir use?

Used as an ointment to treat cold sores caused by HSV

14

Which drug is used to treat CMV but can cause neutropenia, thrombocytopenia, anemia, fever, and renal toxicity?

Ganciclovir

15

Which drug is used to treat CMV retinitis and must be co- administered with probenecid?

Cidofovir

16

Cidofovir MOA?

Inhibits CMV DNA polymerase...

Unlike the other "clovirs" cidofovir is phosphorylated by cellular enzymes (NOT VIRAL ENZYMES!)

17

What is the major issue with cidofovir?

nephrotoxicity is a major adverse effect

(unbalanced) tradeoff - only needs to be administered once a week!

18

Vidarabine, idoxuridine, and trifluridine usage?

HSV keratitis

19

Rank ACT, ACV, and ganciclovir from most selective to least selective

Most - AVC --> ganciclovir --> ACT - Least

20

What are the serious negative side effects of AZT (zidovudine)?

bone marrow suppression --> neutropenia and anemia

21

What is the major cause of toxicity in zidovudine?

inhibition of mitochondrial DNA polymerases + phosphorylated AZT accumulates in all dividing cells in the body

22

Zidovudine MOA?

anti HIV nucleoside analogue - phosphorylated by cellular kinases and then inhibit viral reverse transcriptase

23

Which nucleoside/nucleotide analogue has less toxicity and can be used to treat HBV?

lamivudine

24

What drug can you use to treat serious HSV or CMV infections where acyclovir or ganciclovir have failed?

foscarnet

25

foscarnet MOA? dose limiting adverse effect?

mimics the pyroFOSphate product of DNA polymerization

renal impairment

26

Name the four NNRTIs. What is the clinical use? Major adverse effect? Why do you need to administer with other drugs?

Efavirenz
Nevirapine
Delavirdine
Etravirine

HIV

Rash

Resistance develops quickly

27

What is the MOA of NNRTIs?

bind near the catalytic site of reverse transcriptase and inhibit the enzyme

28

What is the MOA of raltegravir?

inhibits integrase (viral enzyme that helps HIV get into cellular genome)

29

What is the major risk factor of raltegravir and what is its approved use?

suicide risk

HIV but ONLY IN COMBO w other anti-HIV drugs

30

Which drugs inhibit HIV protease?

-navirs

you "navir" tease a protease

31

How do the HIV protease inhibitors work?

they prevent maturation of new viruses

32

Do not administer HIV protease inhibitors with...

P450 substrates or to patients with severe hepatic impairment

33

what is the major adverse effect of protease inhibitors?

dylipidemia - increased cholesterol and triglycerides

34

Which protease inhibitor is combined with other protease inhibitors to reduce the # of pills that need to be taken per day?

ritonavir

35

NNRTIs and protease inhibitors should NOT be administered together why?

both classes of drugs undergo hepatic metabolism

36

NNRTI class toxicity?

liver toxicity

efavirenz
nevirapine
delavirdine
etravirine

37

What are the common side effects of NRTIs? (zidovudine, stavudine, lamivudine, tenofovir...)....what is the underlying cause?

lactic acidosis
neutropenia
myelosuppresion
myopathy

mitochondrial DNA polymerase toxicity

38

Zanamivir and Oseltamivir MOA? Clinical app?

inhibits influenza neuramidase

influenza A & B

39

What are the differences between zanamivir and oseltamivir?

O - prophylaxis and tx; used to treat bird and swine flu

Z - prophylaxis only; inhaler form

40

Fomivirsen (unknown MOA) clinical app?

CMV retinitis

41

WHat drug with an unknown MOA can be used to tx RSV and in combo with interferon alpha, Hep C?

ribavirin

42

Docosanol clinical app?

HSV

43

Interferon alpha clinical app

Hep C, hep B
kaposi sarcoma
CML
hairy cell leuk
malignant melanoma
renal cell carcinoma

44

interferon alpha can cause what besides flu symptoms?

autoimmune disease, neutropenia, thrombocytopenia

45

Imiquimod

tx HPV, basal cell carcinoma, and actinic keratosis

can cause skin irritation so wash hands before and after