Lecture 11: Chemotherapeutics (Part 2): Anti-Viral Drugs Flashcards Preview

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Flashcards in Lecture 11: Chemotherapeutics (Part 2): Anti-Viral Drugs Deck (88)
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1

Viruses are ________, intracellular _________ (i.e. they must live within cells)

obligate
parasites

2

t/f: large and deceptively simple

f: Small and deceptively simple

3

Viruses depend on the ________ _______of the host for ________ and ________/___________

metabolic process
reproduction
replication/survival

4

t/f: Developing drugs that follow selective toxicity can be difficult (toxic to the virus, not host)

t

5

Some viruses have different _______ than host cells.
Drug therapy directed against __________ enzymes
allows greater _______ with less host _______

enzymes
virus-specific enzymes
efficacy
toxicity

6

Viral infection and replication occur in cells in distinct steps.

Drugs may interfere with these steps to be more _______ for the virus cells than host cells

selective

7

t/f: herpes family are all RNA viruses

f: all DNA viruses

8

herpes simplex 1: location

oral-facial including ocular (most common)

9

herpes simplex 2: location

genital and ocular (less common)

10

herpes simplex 1 vs. 2: distinguishably in the eye?

in the eye clinically indistinguishable

11

Varicella-Zoster Virus: 2 types - name them.

Chickenpox
Shingles/Herpes Zoster

12

Cytomegalovirus: 3

Human herpesvirus 6a, 6b, & 7
Epstein-Barr Virus
Kaposi’s sarcoma-associated herpesvirus

13

Drugs to Treat HSV (1+2) and VZV:3

acyclovir
valacyclovir
famciclovir

14

t/f: acyclovir, valacyclovir, famciclovir have a strong activity against Epstein Barr Virus (EBV), cytomegalovirus (CMV), and HHV-6

f: weak

15

when do you ideally want to start acyclovir, valacyclovir, and famciclovir

72 hrs of symptom onset

16

MOA for acyclovir, valacyclovir, famciclovir

All inhibit viral DNA synthesis selectively by inhibiting the viral enzyme DNA polymerase

17

Acyclovir, Valacyclovir, and Famciclovir are ________ _________ __________

Guanine Nucleoside Analogues

18

Guanine Nucleoside Analogues are drugs made to do what?

trick infected cells by the virus by disguising themselves as nucleosides.

19

prodrug: valacyclovir
active drug: _________

acyclovir

20

prodrug: famciclovir
active drug:

penciclovir

21

Bioavailability of acyclovir ____% - needs dosed ____ frequently (__X/day)


Bioavailability of valacyclovir ____% - dosed ____ frequently than acyclovir (__X/day)


Bioavailability of famciclovir ____% - dosed _____ as valacyclovir (3X/day)

Bioavailability of acyclovir 22% - needs dosed more frequently (5X/day)


Bioavailability of valacyclovir 55% - dosed less frequently than acyclovir (3X/day)


Bioavailability of famciclovir 80% - dosed same as valacyclovir (3X/day)

22

Acyclovir, Valacyclovir, Famciclovir are activated (_____________) initially by virus-specific ______ ________

(phosphorylated)
thymidine kinase

23

Acyclovir, Valacyclovir, Famciclovir requires what?

viral kinase for initial phosphorylation

it is only activated in infected cells (selective toxicity), not in uninfected host cells

24

t/f: Acyclovir, Valacyclovir, Famciclovir are not well tolerated?

f: well-tolerated, few systemic adverse effects

25

Adverse Effects Anti-HSV and VZV Drugs

1. Headache

2. GI disturbances

3. Rare, anti-viral induced crystalline nephropathy
administration

4. Rare, CNS symptoms: agitation, hallucinations confusion, encephalopathy in elderly

26

CMV infections occur primarily in advanced _____________(_____ or on _________ that suppress the immune system)

advanced immunosuppression
(AIDS or on medications that suppress the immune system)

27

Dissemination of CMV infection results in end-organ disease including (5) CCREP

1. retinitis
2. colitis
3. esophagitis
4. CNS disease
5. pneumonitis

28

Although the incidence of CMV reactivation in HIV-infected patients has markedly decreased with the advent of ________ drug therapy, clinical reactivation of CMV infection after organ transplantation is still prevalent

antiretroviral drug therapy

29

Drugs to Treat CMV: 4

1. ganciclovir: also topical for HSV

2. valganciclovir: prodrug of ganciclovir

3. cidofovir

4. foscarnet

30

MOA for ganciclovir, valganciclovir, cidofovir

Inhibit CMV DNA polymerase, causes termination of viral DNA synthesis (stops DNA replication)