Non-HIV antivirals Flashcards Preview

Pharm 4 > Non-HIV antivirals > Flashcards

Flashcards in Non-HIV antivirals Deck (32):
1

Acyclovir MOA

2-deoxyguanosine analog; blocks NA synthesis

2

Acyclovir uses

Oral, IV, topical for HSV and VZV

3

Acyclovir metabolism and ADRs

Poor oral availability, short half-life
renal excretion (reduce dose in renal failure)
ADR: GI upset and HA, renal nephropathy d/t crystallization in tubules, pregnancy cat B

4

Valacyclovir

Oral prodrug of acyclovir for HSV, VZV
*better oral availability
pregnancy cat B

5

Famciclovir

oral prodrug of penciclovir

6

penciclovir

similar to ganciclovir
topical only for herpes labialis

7

nucleoside analogs used for CMV

ganciclovir
valganciclovir

8

ganciclovir

analog of nucleoside guanosine
given IV, MOA and metabolism like acyclovir

9

ADR ganciclovir

bone marrow suppression (50%), renal nephropathy, fever, HA
preg cat C

10

valganciclovir

prodrug of ganciclovir
oral; achieves same plasma level as IV ganciclovir

11

foscarnet

pyrophosphate analog that reversibly binds viral DNA polymerase
to treat CMV; alternative for HSV, resistant HSV, VZV

12

foscarnet metabolism and ADR

IV d/t poor oral availability; renal clearance proportional to creatinine clearance
ADR: renal tubular toxicity and crystallization (saline loading needed), seizures, hypocalcemia (binds free Ca), genital ulceration d/t high conc in urine

13

Cidofovir

monophosphate nucleotide analog of deoxycitidine (dCTP) for CMV in HIV patients unresponsive to ganciclovir or foscarnet tx

14

cidofovir metabolism & ADR

No viral kinase req for phosphorlyation
IV d/t poor oral availability
*Must give probenecid and saline before and after infusion to prevent renal tubular secretion and toxicity
ADR: nephrotoxicity and neutropenia

15

treatment strategies for HBV

life-long therapy to sustain suppression of HBV replication to slow progression of hepatic complications; no eradication

16

First-line therapy for HBV

nucleotide/side analogs that inhibit DNApol and cause viral DNA chain termination
Tenofovir, entecavir

17

tenofovir

1st line for HBV, also used for HIV
nucleotide/side analog
ADR: GI things (diarrhea, pain, etc.)

18

entecavir

1st line for HBV
nucleotide/side analog

19

Second-line therapy for HBV

interferon alfa
peginterferon alfa-a2

20

Interferon alfa

second line therapy for HBV

21

peginterferon alfa-a2

second line therapy for HBV, first line for HCV
pegylated prep of interferon alfa with increased half life = less frequent dosing

22

ADR of second line therapy for HBV

flu-like syndrome common, bone marrow suppression, psychiatric disturbances

23

treatment strategies for HCV

eradicate HCV in 24 weeks (genotypes 2,3) or 48 weeks (1; 79% cases)

24

first-line therapy for HCV

types 2,3: peginterferon alfa-a2a or 2b + oral ribavirin
type 1: add teleprivir or boceprivir (protease inhibitors)

25

ribavirin ADR

can cause severe hemolytic anemia

26

teleprivir/ boveprivir

first line therapy for HCV type 1 in combination with peginterferon alfa + ribavirin
protease inhibitors

27

sofosbuvir

nucleotide analog RNA pol inhibitor
prodrug activated in liver
used for chronic HCV in combo with ribavirin (2,3) or ribavirin + peginterferon (type 1)
*well-tolerated

28

oseltamivir/ zanamivir

neuraminidase inhibitors for influenza types A and B prophylaxis and treatment (if give w/i 36 hours of sx onset) for adults and kids

29

MOA of amantadine/ rimantadine

block M2 protein to inhibit uncoating of influenza A virus

30

amantadine use and metabolism

for influenza A prophylaxis and treatment; high resistance now
used as adjunct therapy for PD
90% renal elimination

31

amantadine ADR

Mild: anxiety, insomnia, difficulty concentrating
Severe: delirium, hallucinations, seizures

32

rimantadine

for influenza A prophylaxis and treatment; high resistance now