Exam 8: Antivirals Flashcards Preview

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Flashcards in Exam 8: Antivirals Deck (58):
1

Gamma Globulin Mechanism

Prevent attachment and penetration of viral particles

2

Gamma globulin adverse effects?

Systemic anaphylaxis

3

Pavilizumab

Monoclonal Antibody to RSV
Used in high risk infants by IV administration

4

Amantidine Mechanism

Blocks the M2 viral protein and causes buffering of the endosomal pH, preventing viral penetration and uncoating

5

Amantidine Uses (2)

1. Influenza A Respiratory tract illness (Not effective against B)
2. Also used as an Antiparkinsonian agent

6

What surface Antigens are used to type Influenza?

Hemagglutinin
Neuraminidase
(example: H1N1)

7

What is Neuraminidase important for?

A cleavage reaction required for release of virions from infected cells

8

What is Hemagglutinin important for?

Attachment of the virus to silica acid residues on the cell (important for penetration

9

Zanamivir mechanism

Inhibits neuraminidase of Influenza virus

10

Zanimivir uses

Influenza A and B

11

Oseltamivir Mechanism

Inhibits neuraminidase of Influenza virus

12

What is the difference between Zanamivir and Oseltamivir?

Oseltamivir can be taken orally and reaches places other than the respiratory tract.

13

Ribavirin Mechanism

Purine analog
Inhibits viral RNA synthesis

14

Ribavirin Uses (2)

1. RSV in infants and young children
2. Chronic Hepatitis C (with IFN alpha)

15

Ribavirin Adverse Effects

Teratogenic
Pregnant healthcare workers should avoid caring for patients receiving aerosolized Ribavirin

16

Trifluridine Mechanism

Pyrimidine analog (Thymidine)
Inhibits viral DNA synthesis

17

Trifluridine Uses

HSV1 and 2
Used topically for HSV keratoconjunctivitis or keratitis

18

Trifluridine Adverse Effects

Teratogenic

19

Acyclovir Mechanism

Purine Analog derived from Guanine
Must be phosphorylated to be active (done by Herpes' intrinsic Tyrosine Kinase)
Inhibits viral DNA polymerase

20

How is Acyclovir selective?

It must be activated by a viral Tyrosine kinase.
Makes it non toxic to normal human cells

21

What is a problem with Acyclovir use?

Resistance is starting to occur.

22

Acyclovir uses

IV against Herpes viruses (all kinds of manifestations)
Topical agains mucocutaneous and keratitis caused by herpes
Also taken orally for VZV and herpes in the immunocompromised

23

Gancyclovir Uses

Cytomegalovirus retinitis

24

Gancyclovir Adverse effects (3)

1. Teratogenic and carcinogenic
2. Granulocytopenia, thrombocytopenia
3. Myelosuppression

25

Foscarnet mechanism

Inhibits Viral DNA polymerase

26

Foscarnet use

used for cytomegalovirus retinitis in AIDS patients!

27

Foscarnet advise effect

Renal Toxicity

28

Name 3 Hep B drugs

Lamivudine
Tenofovir
Emtricitabine

29

Interferon Alpha Mechanism

Alarm Molecule
Signals neighboring cells to prepare to defend themselves form viral infection.
Cells produce enzymes that inhibit viral transcription, translation, protein processing, and virus maturation.

30

Interferon alpha uses

1. Cutaneous warts
2. Herpes keratoconjunctavitis
3. Hepatitis B and C (+ribavirin)
4. Also some cancers (bladder, karposi, hairy cell lymphoma)

31

Interferon alpha adverse effects

mild/moderate
flu like syndrome
muscle pain
NV
etc.

32

What are 5 nucleoside reverse transcriptase inhibitors?

Zidovudine
Didanosine
Lamivudine
Abacavir
Emtricitabine

33

Name 1 nucleotide reverse transcriptase inhibitor

Tenofovir
NucleoTide--Tenofovir

34

Name 1 non-nucleoside reverse transcriptase inhibitor

Efavirenz

35

Name 5 Protease Inhibitors

Ritonavir
Indinavir
Nelfinavir
Lopinavir
Atazanavir
*** They all end in NAVIR

36

Zidovudine Mechanism

Nucleoside Reverse Transcriptase Inhibitor (causes chain termination, inhibition of viral replication)

37

Zidovudine Pharmacokinetics

Good CNS penetration

38

Zidovudine Adverse Effects (2)

1.GI disturbances
2. Bone marrow Toxicity

39

What drug is used to prevent transmission of HIV from mother to child?

Zidovudine

40

What is a major use of Zidovudine?

To prevent transmission of HIV from mother to child

41

Didanosine Mehcanism

Nucleoside Reverse Transcriptase Inhibitor (causes chain termination, inhibition of viral replication)

42

Didanosine Adverse Effects (3)

1. Peripheral Neuropathy
2. Pancreatitis
3. GI effects

43

Lamivudine Mechanism

Nucleoside Reverse Transcriptase Inhibitor (causes chain termination, inhibition of viral replication)

44

Lamivudine Advantage

Less toxic than other drugs
Also treats Hep B

45

Abacavir mechanism

Nucleoside Reverse Transcriptase Inhibitor (causes chain termination, inhibition of viral replication)

46

How do non nucleoside RTIs work?

they bind directly to the reverse transcriptase enzyme and inhibit its activity

47

Emtricitabine Mechanism

Nucleoside Reverse Transcriptase Inhibitor (causes chain termination, inhibition of viral replication)

48

Emtricitabine Adverse effect

Pigmentation of palms of hands and soles of feet

49

Tenofovir Mechanism

NucleoTide Reverse Transcriptase Inhibitor (causes chain termination, inhibition of viral replication)

50

Tenofovir use besides HIV

Hep B

51

What is a pharmacokinetic interaction with non nucleoside RTIs?

p450 metabolism

52

Efavirenz

Non nucleoside RTI
metabolized by p450
Cause headache, rash, insomnia
Also can cause neural tube defects

53

Adverse effects of Ritonavir

NVD
Paresthesias

54

Use of Ritonivir

Boost serum concentrate of other PIs

55

Adverse effect of Indinavir

Nephrolithiasis

56

Nelfinavir adverse effects

GI problems

57

What are the preferred PIs for naive patients?

Ritonavir boosted Atazanavir

58

What are the preferred NRTI treatments for naive patients? (2)

1. Abacavir/Lamivudine
2. Emtricitabine/Tenofovir