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Pharmacology > Exam 3: Antivirals > Flashcards

Exam 3: Antivirals Flashcards

1
Q

What are the 3 antivirals for HSV/VZV?

A

Acyclovir, valacyclovir, and docosanol

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2
Q

What are the 3 antivirals used for influenza?

A

Oseltamivir, zanamivir, and baloxavir

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3
Q

What are the 3 antivirals used for Hepatitis B?

A

Tenofovir, entecavir, and lamivudine

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4
Q

What are the 4 antivirals used for CMV/Herpes?

A

Ganciclovir, valganciclovir, Foscarnet, and Cidofovir

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5
Q

What is the antiviral used for RSV?

A

Ribavirin

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6
Q

What are the 2 antivirals used for Hep C?

A

Sofosbuvir/ledipasvir and Sofosbuvir/velpatasvir

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7
Q

What is the DOC for HSV/VZV?

A

Acyclovir

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8
Q

What is the MOA of acyclovir?

A

Phosphorylated/activated by viral thymidine kinase in infected cells
Inhibits DNA polymerase by competing with dGTP

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9
Q

How does resistance to Acyclovir develop?

A

Decrease in thymidine kinase

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10
Q

What are the adverse effects of acyclovir?

A
  • Generally well tolerated because drug is mostly concentrated within virus.
  • Nephrotoxicity with high IV doses (hydration is very important)
  • Safe in pregnancy
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11
Q

What is the MOA of Docosanol (abreva)?

A

Inhibits viral fusion to host plasma membrane so the virus cannot get into the cell

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12
Q

What is docosanol used for?

A

OTC and topical for cold sores/herpes simplex.

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13
Q

What is the MOA of Ganciclovir/valgancilovir?

A

Phosphorylated/activated by viral kinases in infected cells

Inhibits DNA polymerase

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14
Q

What is the DOC for CMV?

A

Ganciclovir

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15
Q

What are the toxicities associated with ganciclovir/valganciclovir?

A
  • Myelosuppresion: Leukopenia, neutropenia, and thrombocytopenia
  • CNS effects: headache, confusion, seizures
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16
Q

What is the MOA of foscarnet?

A

Directly inhibits DNA and RNA polymerase and reverse transcriptase. Does not require phosphorylation for activity

17
Q

What kind of toxicity do all parental antivirals have? How should you combat this?

A
  • They all are renal toxic

- Combated with aggressive hydration

18
Q

How is CMV encephalitis treated?

A

Foscarnet + ganciclovir

19
Q

How is CMV retinitis treated?

A
  • Oral, IV, or ocular implant ganciclovir (replace ocular implant every 5-8 months)
  • If ganciclovir resistant, treat with foscarnet
20
Q

What is the MOA of cidofovir?

A
  • Inhibits viral DNA polymerase

- Does not require phosphorylation for activity

21
Q

Are are the toxicities associated with Cidofovir?

A

-Dose dependent nephrotoxicity

22
Q

What is the MOA of Oseltamivir/zanamivir?

A

Neuraminidase inhibitors, blocks the release of the virus from cells

23
Q

What are oseltamivir/zanamivir used to treat?

A

-Influenza A and B (start within 48 of symptom onset)

24
Q

Who are oseltamivir and zanamivir approved for?

A
  • Oseltamavir: oral, approved for patients >1 year

- Zanamavir: Nasal or oral inhaler, approved for patients > 7 years

25
Q

What is the MOA of Baloxavir Marboxil (XoFluza)?

A

-Endonuclease activity of the PA protein, the drug prevents viral gene transcription and ultimately viral replication

26
Q

What is the use of Baloxavir Marboxil?

A
  • Active against influenza A and B if started within 48 hours
  • Approved for > 12 years, single dose
27
Q

What is the MOA of Ribavirin?

A
  • Inhibits RNA polymerase and synthesis of GTP

- Phosphorylated by host enzymes

28
Q

What is Ribavirin used for?

How can it be administed?

A
  • RSV (aerosol) and hepatitis C

- Aerosol, IV, Oral

29
Q

What are the toxicities associated with ribavirin?

A
  • Oral: Dose dependent hemolytic anemia
  • Aerosol: Respiratory depression, cardiac arrest, hypertension
  • IV: Psychiatric, depression, suicide

Extremely teratogenic, do no conceive for at least 6 months after exposure to drug

30
Q

What is the DOC for hepatitis B?

A

Tenofovir

31
Q

What is the MOA for Tenofovir?

A

Inhibits HBV DNA polymerase; reverse transcriptase inhibitor also used for HIV

32
Q

What is the MOA of Entevcavir?

A

Inhibits HBV DNA polymerase

33
Q

What is the MOA of Lamivudine?

A

Inhibits HBV polymerase

34
Q

What two hepatitis B drugs have a good safety profile, even in those with advanced disease?

A

Tenofovir and entecavir

35
Q

What is the MOA of sofosbuvir?

A

Inhibits viral NS5B RNA polymerase, blocking replication of HCV when the uridine analogue is incorporated, causing termination

36
Q

What is the MOA of Ledipasvir/Velpatasvir?

A

Inhibits HCV NS5A protein and may prevent phosphorylation and replication

Pharmacology (25 decks)

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