Pharmacology - Antiviral Therapy I and II Flashcards Preview

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Flashcards in Pharmacology - Antiviral Therapy I and II Deck (83):
1

Class: Acyclovir; Penciclovir

Purine analog (guanosine)

2

Class: Valacyclovir; Famciclovir

Purine analog (guanosine)

3

MOA: Valacyclovir; Famciclovir

Prodrug converted to Acyclovir & Penciclovir,respectively --> After phosphorylation, causes viral DNA chain termination

4

MOA: Acyclovir; Penciclovir

After phosphorylation, causes viral DNA chain termination

5

Class: Ganciclovir

Purine analog (guanine)

6

MOA: Ganciclovir

After phosphorylation, causes viral DNA chain termination

7

Class: Foscarnet

Pyrophosphate congener

8

MOA: Foscarnet

Directly inhibits HSV DNA polymerase or HIV reverse transcriptase

9

Use: Foscarnet

Broad spectrum (HSV/VZV/CMV, and RNA viruses including HIV)

use for resistant strains only due to toxicity concerns

10

Use: Ganciclovir

Treatment & prophylaxis of CMV infection (but also HSV, VZV)

**Valganciclovir for PO bc of much higher bioavailabiltiy

11

Use: Valacyclovir; Famciclovir;
Acyclovir; Penciclovir

HSV, VZV (requires higher dose than HSV)

12

Side effects: Valacyclovir; Famciclovir;
Acyclovir; Penciclovir

CNS changes and renal dysfunction possible when used at higher doses

13

Side effects: Ganciclovir

Neutropenia, thrombocytopenia

14

Side effects: Foscarnet

Dose-dependent renal and CNS toxicities, electrolyte & metabolic abnormalities;
Myelosuppression

15

What specific scenario is Foscarnet recommended for?

Used for invasive HSV/VZV infections from acyclovir resistant strains; alternative to ganciclovir for CMV

16

Side effects: Tenofovir

Nephrotoxicity;
Lactic acidosis;
GI issues

17

Side effects: Abacavir

Hypersensitivity reaction;
Lactic acidosis;
GI issues

18

Side effects: Zidovudine

Anemia;
Granulocytopenia
Lactic acidosis;
GI issues

19

Class: Zidovudine

NRTI

20

Class: Lamivudine (Epivir); Emtricitabine (Emtriva)

NRTI

21

Class: Tenofovir

NRTI

22

Class: Abacavir

NRTI

23

Class:
Efavirenz (Sustiva);
Nevirapine (Viramune); Rilpivirine (Edurant);
Etravirine (Intelence)

NNRTI

24

MOA: NRTIs
Zidovudine;
Lamivudine;
Emtricitabine;
Tenofovir;
Abacavir

Inhibits reverse transcriptase

25

Use: Abacavir, Zidovudine

HIV

26

Use: Lamivudine, Emtricitabine, Tenofovir

HIV and HBV

27

Side effects: Lamivudine (Epivir); Emtricitabine (Emtriva)

Headache; N & V; rash; neutropenia; pancreatitis

28

Side effects: Efavirenz

• CNS symptoms!!
-vivid dreams
-drowsiness
• Teratogenic

29

Side effects: Nevirapine

Rash;
Hepatitis including hepatic necrosis

30

Side effects: Etravirine

Rash;
Increased LFTs

31

Side effects: Rilpivirine

Rash;
QT prolongation

32

Class: Efavirene;
Nevirapine;
Rilpivirine;
Etravirine

NNRTIs

33

MOA: NNRTIs
Efavirene;
Nevirapine;
Rilpivirine;
Etravirine

Inhibit reverse transcriptase through direct enzyme inhibition instead of a nucleoside base

34

Use: NNRTIs
Efavirene;
Nevirapine;
Rilpivirine;
Etravirine

HIV

35

Side effects: Protease Inhibitors

GI intolerances - N/V, diarrhea;
Dyslipidemia;
Hyperglycemia;
Lipodystrophy

36

Class:Ritonavir (Norvir);

Protease inhibitor

37

Class: Fosamprenavir

Protease inhibitor

38

Class: Atazanavir

Protease inhibitor

39

Class: Darunavir

Protease inhibitor

40

Class: Lopinavir

Protease inhibitor

41

MOA: Protease inhibitors

Prevent cleavage of protein chain into functional subunits

42

Use: Protease inhibitors
Ritonavir
Fosamprenavir
Atazanavir
Darunavir
Lopinavir

HIV

43

T/F: Resistance can develop slowly with use of protease inhibitors.

True

44

These drugs belong to what class and are used to treat HIV:
Ritonavir
Fosamprenavir
Atazanavir
Darunavir
Lopinavir

Protease inhibitors

45

Side effects: Enfuvirtide

Local injection sight reaction (pain, erythema, induration, nodules, and cysts)
Increased rate of bacterial pneumonia
Hypersensitivity reaction

46

Class: Enfuvirtide

Entry inhibitor (also its MOA)

47

Class: Maraviroc

CCR5 antagonist (entry inhibitor)

Must test to see if virus is using CCR5 before administration

48

Use: Enfuvirtide, Maraviroc

HIV

49

How is Enfuvirtide administered?

Injectable

50

Side effects: Maraviroc

Hepatotoxicity - rare;
Cough, fever, upper RTIs, Rash, musculoskeletal symptoms, abdominal pain, dizziness

51

HIV often uses what co-receptors for entry into T-cells?

Chemokine (C-C motif) receptor 5 (CCR5) AND CXCR4

Maraviroc inhibits CCR5, no inhibitor exists yet for CXCR4.

52

Class: Raltegravir

HIV Integrase inhibitor

53

Class: Elvitegravir

HIV Integrase inhibitor

54

Class: Dolutegravir

HIV Integrase inhibitor

55

What is the function of HIV integrase?

Inserts viral DNA into human genome

56

MOA: HIV Integrase inhibitors
Raltegravir;
Elvitegravir;
Dolutegravir

Binds to HIV integrase to prevent viral DNA strand transfer

57

Use:
Raltegravir;
Elvitegravir;
Dolutegravir

HIV

58

Side effects: HIV Integrase inhibitors

Headache;
Low side effect profile

59

What are the common combinations for HAART?

1. Integrase inhibitor + 2 NRTIs
2. PI (+/- Ritonavir boosting) + 2NRTIs
3. NNRTI and 2 NRTIs

60

Class: Sofosbuvir

NS5B Polymerase Inhibitor

61

Class: Paritapevir

NS5B Polymerase Inhibitor

62

MOA: NS5B Polymerase Inhibitors (Sofosbuvir, Paritapevir)

Compete with viral nucleotide to cause viral chain termination of HCV RNA

63

Use: Sofosbuvir, Paritaprevir

HCV

64

Side effects: Sofosbuvir, Paritaprevir

Few side effects; fatigue, headache, anemia possible

65

Class: Ledipasvir

NS5A inhibitor

66

Class: Daclatasvir

NS5A inhibitor

67

Class: Ombitasvir

NS5A inhibitor

68

What is the function of NS5A in HCV?

NS5A is a viral phosphoprotein required for viral replication.

69

Use: Ledipasvir; daclatasvir; ombitasvir

HCV

70

MOA: Simeprevir; Bocepravir; Telapravir

Prevent viral maturation through the inhibition of protein synthesis

NS3/4A protease inhibitors

71

Use: Simeprevir; Bocepravir; Telapravir

HCV

72

Side effects: Simeprevir; Bocepravir; Telapravir (NS3/4A protease inhibitors)

Anemia, rash, itching, GI side effects

73

Class: Simeprevir

NS3/4A protease inhibitors

74

Class: Bocepravir

NS3/4A protease inhibitors

75

Class: Telapravir

NS3/4A protease inhibitors

76

Are HCV treatments typically given in combination?

YES

For example:
Sofosbuvir + Ledipasvir;
Simeprevir + Sofosbuvir;
Ombitasvir + Paritaprevir + Ritonavir

77

Drug therapy for treatment of influenze should be started when?

Early in the course of the disease, otherwise the clinical benefits are limited

78

Class: Oseltamivir

Neuraminidase inhibitor

79

Class: Zanamivir

Neuraminidase inhibitor

80

Class: Peramivir

Neuraminidase inhibitor

81

MOA: Neuraminidase inhibitors - Oseltamivir, Zanamivir, Peramivir

Inhibits an enzyme critical in penetration of respiratory tract mucus and in the release of virus from infected cells
Effective against influenza A and B

82

What is the route of administration of Zanamivir?

Inhaled therapy

83

Side effects: Neuraminidase inhibitors - Oseltamivir, Zanamivir, Peramivir

Neuropsychiatric toxicity has been reported, GI side effects, brochospasm with zanamivir