Pharmacology Infectious Disease Flashcards
(209 cards)
1
Q
Ethambutol
A
Bacteriostatic antimycobacterial drug used in the treatment of Tb
2
Q
What is ethambutol often given with for treatment of active Tb
A
Isoniazid, rifampin, and pyrazinamide
3
Q
MOA ethambutol
A
Blocking bacterial arabinosyltransferase enzyme, which polymerizes carbohydrates in the bacterial cell wall. Therefore, leading to increased permeability of the cell wall
4
Q
Side effects ethambutol
A
Eyes, optic neuritis, red green color blindness
5
Q
MOA ethambutol
A
Bacteriostatic
Interfering with bacteria protein production, DNA replication, metabolism without directly harming the organism.
Blocks arabinosyltransferase, which polymerizes carbohydrates in the bacterial cell wall
6
Q
Side effects ethambutol
A
Red green color blindness and decreased visual acuity. Optic neuritis, which results in color blindness, central scotoma and decreased visual acuity
7
Q
Discontinuation of ethambutol can lead to what
A
Visual disturbances
8
Q
Isoniazid
A
Drug used in the treatment of both latent and active tb. It can be used as a mono therapy for the treatment of latent Tb but is commonly used in a four drug regime including pyrazinamide, ethambutol, rifampin for active TB
9
Q
Isoniazid is a pro drug that required bacterial catalase peroxidase enzyme to activate it and works by inhibiting the synthesis of __ __
A
Myolic acid
10
Q
Isoniazid is metabolized by the __ via ___
A
Liver
Acetylation
11
Q
There are two forms of the acetylation enzyme :
A
Fast acetylator
Slow acetylator
12
Q
People with fast acetylator
A
Metabolize the drug more quickly than the slow acetylator
13
Q
Side effects osiniazis
A
Vitamin B6 defiency
Hepatotoxicity and neurotoxicity
Drug induced lupus erythematosus
14
Q
Indications isoniazid
A
TB
15
Q
MOA isoniazid
A
Inhibits synthesis of mycolic acid
16
Q
Is isoniazid used for active of latent TB
A
Both
17
Q
How is isoniazid used for latent TB
A
Monotherapy
18
Q
How is TB used for active TB
A
Four drug regime
Pyrazinamide, ethambutol, rifampin
19
Q
MOA isoniazid
A
- must be activated by bacterial catalase peroxidase bc it is a pro drug
- inhibits synthesis of mycolic acids which is necessary for synthesis of the mycobacterial cell wall
- Metabolized in liver fast or slow depending on acetylators
20
Q
Side effects isoniazid
A
B6 defiency (peripheral neuropathy and sideroblastic anemia)
Neurotoxicity (associated with B6 defiency)
Hepatotoxicity
Drug induced lupus
21
Q
Rifampin
A
Bactericidal antibiotic commonly used int he treatment of active TB
22
Q
MOA rifampin
A
Inhibits bacterial RNA stnthesisby inhibiting RNA polymerase.
23
Q
Why does rifampin resistance develop quickly
A
Due to alteration of the binding sites on RNA polymerase so monotherapy should not be used
24
Q
Monotherapy rifampin
A
NO
25
What is rifampin used in combo with
Other antibiotics
26
Indications for rifampin
TB
Haemophilus influenza
Leprosy
Meningitis
27
Rifampin is a p450 inducer....causing what
Increased rate of metabolism of other drugs that are cleared by the liver through the p450 system
28
Side effect rifampin
P450. Inducer
Bodily fluids (urine and tears) to become orange red in color which may be alarming but is completely benign
29
TB rifampin
Bactericidal antibiotic used for active TB, but never monotherapy due o high resistance rates
30
What is rifampin used with to treat active TB
Isoniazid, ethambutol, and pyrazinamide
31
MOA rifampin
Blocks RNA polymerization
32
Indications for rifampin
TB, haemophilus influenza, leprosy, Hansen’s disease (rifampin with dapsone and clofazimine)
Meningitis prophylaxis
33
Azoles (ketoconazole)
Antifungal medication that work by inhibiting fungal ergosterol synthesis, disabling the fungus from growing
34
Indications for azoles (ketoconazole)
Local and lessserious systemic mycoses
35
Side effects azoles (ketoconazole)
Liver dysfunction and testosterone synthesis inhibition
36
Azoles suffix
Azole
37
Examples of azoles
Fluconazole
| Ketoconazole
38
Indications for azoles
Local and less serious systemic mycosis
Exception is fluconazole-used for chronic suppression of cryptococcus, along with candidiasis in AIDS patients
39
MOA azoles
Inhibits ergosterol synthesis leaving to defective cell membrane synthesis in fungi
Inhibits p450 to do this.
In fungus cp450 is responsible for converting lanosterol to ergosterol, and inhibition of it leads to defect cell membrane synthesis
40
Side effects azoles
Liver dysfunction
Inhibition of testosterone synthesis by inhibiting cholesterol desomolase which can lead to gynecomastia and hormone imbalance
41
Amphotericin B
Polyene medication which works by binding to ergosterol in fungal cell membranes.
42
MOA amphotericin B
Bind to ergosterol in fungal cell membrane
| Forms membrane pores, causing electrolytes to leak, killing the cell
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Indications for amphotericin B
Serious systemic mycoses
44
Side effects emphotericin B
Fever, chills, nephrotoxicity, arrhythmias, anemia and IV phlebitis
45
Indications for amphotericin B
```
Systemic mycosis (eg crytococcus)
Fungal meningitis (eg cryptococcal meningitis)
Last resort for protozoan infections (eg visceral leishmaniasis and amoebic meningoencephalitis from naegleria Fowleri)
```
46
MOA amphotericin B
Polyene that binds to ergosterol and forms membrane pores allowing leak of electrolytes, killing the fungal cell
Ergosterol is a component of fungal membranes
47
Side effects amphotericin B
Fever, chills, nephrotoxicity, hypotension, arrhythmias, anemia, IV phlebitis
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“Shake and bake” amphotericin B
Fever and shaking
49
How make nephrotoxicity from amphotericin B less
Coal minister with liposomes
50
Hypotension amphotericin B
Bc of histamine release
51
Arrhythmias and amphotericin B
Due to Renal tubular damage, potassium and magnesium levels can be altered. Can lead to arrhythmias and ventricular fibrillation and cardiac failure
52
Flucytosine
Antifungal for treating cryptococcal meningitis and candida
53
What is fluctosine typically combined with
Amphotericin B
54
MOA flucytosine
Inhibiting DNA and RNA synthesis by being converted to 5-FU by cytosine deaminase in the fungal cell.
55
Side effect flucytosine
Bone marrow suppression
56
Indications flucytosine
Cryptococcus (cryptococcus meningitis in immunocompromised patients)
, candida (candida cystitis)
, used in combination with amphotericin B or azoles
57
Why is flucytosine used in combination with amphotericin b or azole antifungal
Due to its weak antifungal effects and susceptibility to resistance
58
MOA flucytosine
Inhibits and disrupts DNA and RNA biosynthesis by being converted to 5-FU which is an antimetabolite. In the fungal cel, cytosine deaminase converts fluctosine into 5-FU, which blocks the synthesis of thymidine ( a building block of DNA)
59
Side effects flucytosine
Bone marrow suppression—>anemia, leukopenia, pancytopenia, agranulocytosis
60
Is flucytosine toxicity reversible
None can lead to death, notably in immunocompromised patients
61
Griseofulvin
Oral antifungal medication used to treat infections of the skin.
62
Indication for griseofulvin
Ringworm and tinea infections but has several side effects
63
Side effects griseofulvin
Headache, confusion, teratogenic effects and inducing cytochrome p450
64
MOA griseofulvin
Interferes with mitotic spindle synthesis by binding to tubules and disrupting microtubule formation in fungal cells
65
Griseofulvin indications
Antifungal for superficial infections (ringworm or tinea-hair, nail, or large body surfaces)
INHIBITS DERMATOPHYTES which may cause ringworm or tinea. Can be used for all tineas(Curry’s, pedis, capitis, corporis)
66
Side effects griseofulvin
Teratogen
P450 inducer
Confusion
Headache
67
Terbinafine
Antifungal med which is indicated for use against dermatophytes (tinea cruris, pedis and corporis), as well as onchyomycosis
68
MOA terbinafine
Inhibiting squalene epoxidase, leading to fungal cell lysis and death
69
Indications terbinafine
Dermatophytosis (skin fungal disease-tinea pedis, tinea cruris, tinea corporis)
Onychomycosis (fungal nail infections) bc other topical agents cant penetrate nail beds deeply. It is given orally and acts systemically so can get under the nail bed
70
MOA terbinafine
Inhibits squalene epoxidase which is responsible for ergosterol synthesis. This changing cell membrane permeability leading to fungal cell lysis and death
71
Side effects terbinafine
Hepatotoxicity
GI distress
Taste disturbances
Headache
72
Chino candies
Antifungal meds that work by inhibiting cell wall synthesis
73
MOA exhinocandins
Inhibit the synthesis of beta-glucan
74
Indications for echinocandins
Invasive aspergillosis and candida
75
Side effects echinocandin
GI upset and flushing, due to histamine release
76
Echinocandins
Fungin
77
Examples of echinocandins
Caspofungin
| Micafungin
78
Indications echinocandins
Invasive aspergillosis (intolerant. To amphotericin B or itraconazole)
Candida (also invasive candidiasis (abdominal abscesses, peritonitis, pleural cavity infections, esophagitis))
79
MOA echinocandins
Inhibits cell wall synthesis by inhibiting the enzyme that makes beta glucagon, which is an integral part of fungal cell walls
80
Side effects echinocandins
GI distress
| Flushing (can promote histamine release)
81
Nystatin
Polyene medication that works by binding ergosterol and forming membrane pores in the fungus it is treating.
82
Indication for nystatin
Candidiasis and administered for topical infections bc it is too toxic for systemic administration
83
MOA nystatin
Amphotericin B same
84
Indications for nystatin
Candidiasis (vaginal, oral, cutaneous)
85
MOA nystatin
It is a polyene, so it binds to ergosterol and forms membrane pores , allowing leakage of electrolytes, destroying the fungal cell
86
Topical form of nystatin
Polyene and shares same MOA and amphotericin B . Nystatin however is too toxic for systemic use, and works well with cutaneous and topical infections
87
Side effects nystatin
Rash
88
Acyclovir (Zovirax)
Antiviral medication that inhibits viral replication in organisms of the herpes virus family
89
Indication for acyclovir (zoviraz)
Herpes infections and varicella zoster virus
90
Side effects oral acyclovir (Zovirax)
Nausea, vomiting, diarrhea and headache
91
Side effects IV acyclovir
Nephrotoxicity and neurotoxicity
92
Special considerations acyclovir
Preventing recurring episodes of herpes simplex virus and administering IV acyclovir at a slow rate
93
MOA acyclovir
-it is a nucleoside analog medication. Specifically a guanosine analog, and lacks 3’ group, which is necessary for addition of the next nucleotide. Thus when added to a growing DNA chain, synthesis is halted
Inhibits viral replication . This medication directly targets the thymidine kinase formed by herpesviruses and does not affect human DNA
Uses viral thymidine kinase to convert it into acyclovir monophosphate. This is converted into another compound which then inactivated and competitively inhibits DNA polymerase, halting DNA synthesis in viral cells
94
Indications acyclovir
HSV
| Varicella zoster
95
Topical acyclovir
Initial genital herpes simplex
96
Oral acyclovir
Both initial and recurrent oral and genital herpes infections
Varicella within 24 hours of developing rash
High doses if older adult
97
IV acyclovir
Severe genital herpes infection, or immunocompromised patients with oral herpes
Immunocompromised patients with varicella zoster
98
Side effects acyclovir oral
Headache
| GI distress
99
Side efects acyclovir IV
```
CNS toxicity (esp renal impairment)
Nephrotoxicity (buildup of acyclovir in body can causes neurotoxicity like agitation, tremors, hallucinations, and delirium. Also sudden jerking))
```
Nephrotoxicity (crystalline nephropathy-increased BUN and creatinine)
100
Ganciclovir
Antiviral medication used to treat CMV infections int he immunocompromised
101
MOA ganciclovir
Guanosine analog, that is phosphorylation by a viral kinase to form a competitive inhibitor of nucleotide incorporation into DNA)...thus inhibiting viral DNA polymerase
102
Side effects ganciclovir
Hematologic also effects, along with renal toxicity
103
Indications ganciclovir
CMV
| Immunocompromised (HIV, more susceptible to CMV)
104
MOA ganciclovir
Guanosine analog which is phosphorylation by a viral kinase encoded by CMV during infection...leading to the formation of ganciclovir triphosphate
Disrupts DNA synthesis-ganciclovir triphosphate is a competitive inhibitor of nucleotide incorporation into DNA, leading to disrupted DNA synthesis
Ganciclovir triphosphate, which is formed by viral processing of ganciclovir, preferentially inhibits viral DNA polymerase, disrupting viral DNA synthesis
105
Side effects ganciclovir
Hematologic effects
| Nephrotoxicity
106
Foscarnet
Antiviral medication used to treat CMV retinitis in immunocompromised that have failed ganciclovir therapy or acyclovir resistant HSV
107
Indications for foscarnet
CMV retinitis
| Acyclovir resistant HSV
108
MOA foscarnet
Inhibiting viral DNA polymerase and does not require activation by a viral kinase
109
Side effect foscarnet
Nephrotoxicity
| Resistance when their DNA polymerase mutates
110
MOA foscarnet
1. does not require activation by thymidine kinases
2. Inhibits viral DNA polymerase by binding to pyrophosphate(it is a pyrophosphate analog)-binding site of this enzyme..inhibiting elongation of viral DNA
111
How does foscarnet gain resistance
Mutate DNA polymerase so foscarnet cant bind anymore
112
Side effects foscarnet
Nephrotoxicity, electrolyte abnormalities
113
What sort of electrolyte abnormalities do you get with foscarnet
Hypokalemia, hypocalcemia, hypomagnesemia
114
What level of k is hypokalemia and what are symptoms
Under 3.5 mEq/L
| Muscle weakness, arrhythmias, presence of U waves, constipation, hyporeflexia
115
What level is hypocalcemia and what are the symptoms
8.5 mg/dL
Decreased bone density, muscle spasms, tetany, increased DTR, prolonged QT interval
116
What level is hypomagnesia and what are symptoms
1.5mEq/L
Increased DTR, seizures, muscle cramps, tremors, insomnia, and tachycardia
117
Fusion inhibitors / entry inhibitors
Medications that are often used in combination therapy to prevent binding, fusion and entry of the HIV vision into the host cell.
118
Two fusion inhibitors
Enfuvirtide
| Maraviroc
119
MOA enfuviritde
Binding gp41 (a HIV protein) and interferes with this ability to fuse CD4 cells
120
MOA maraviroc
Binds CCR5 preventing its interaction with viral gp120
121
Indications fusion inhibitors
HIW infection, as part of multidrug therapy
122
Maraviroc MOA
Binds CCR5 on CD4 (chemokine receptor), preventing its interaction with viral gp120 disallowing viral entry into the human cell
123
Enfuvirtide MOA
Binding to gp21 (an HIV protein) and interferes with its ability to fuse with CD4 cells
Inhibits viral entryleading to defective fusion
124
Side effects fusion proteins
Skin reactions at injection sites
125
Protease inhibitors
Inhibit the maturation of new viruses, by selectively binding to viral proteases and inhibiting replication.
126
Indication for protease inhibitors
HIV/AIDS and hepc
127
Side effects protease inhibitors
Nephropathy, lidodystrophy, hyperglycemia, and GI distress
128
Suffix protease inhibitors
Navir
129
Examples of protease inhibitors
Ritonavir and indinavir
130
HIV and protease inhibitors
Inhibit HIV-1 protease
131
Protease inhibitors and hepatitis C
Treat hepatitis caused by hepatitis C
132
MOA protease inhibitors
Inhibit protease, which is required for viral replication. (Viral proteases cleave proteins for viral maturation)
133
Virus maturation
Occurs by assembling functional units, which are made from polypeptides that were cleaved by protease. By inhibiting viral protease, these functional protein precursors cant be cleaved, and a new, mature, infectious virus cant be assembled.
134
Side effects protease inhibitors
GI distress,
Nephropathy
Lipodystrophy(abnormal degeneration of fat)
Hyperglycemia (insulin resistance
135
Integrate inhibitors
Class of antiretroviral medication, which are used to treat HIV.
136
MOA integrate inhibitors
Inhibit HIV genome integration into the host DNA, by inhibiting HIV integrate. This medication can lead to insomnia and hypercholestermia.
137
Suffix of integrate inhibitors
Gravir
138
Example of integrate inhibitors
Raltegravir
139
Indications integrate inhibitors
HIV, with other meds
140
MOA integrate inhibitors
Blocks insertion of HIV viral genome into host chromosome
-block viral genome integration by reversible inhibiting HIV integrate, the viral enzyme which integrate the viral genome
141
Side effects integrate inhibitors
Hypercholestermia
Increased LFTs (AST, ALT and bilirubin)
Insomnia
Increased CK (muscle pain)
142
Non nucleoside reverse transcriptase inhibitors (NNRTIs)
Class of medication designed to bind to reverse transcriptase to inhibit viral DNA elongation.
143
What are NNRTIs often combined with
Other therapies
144
What is different about NNRTI from NRTI
Don’t require intracellular metabolism
145
Side effects NNRTIs
Hepatotoxicity, vivid dreams and CNS effects
146
NNRTIs contraindicated
Pregnant women
147
Indication NNRTI
HIV
148
MOA NNRTI
1. dont need intracellular metabolism or phosphorylation
| 2. inhibit reverse transcriptase(different site from NRTI), preventing viral DNA from being transcripts
149
Side effects NNRTI
Rash
| Hepatotoxicity, vivid dreams and CNS symptoms
150
Which NNRTI causes vivid dreams and CNS symptoms
Efavirenz
151
Why no give NNRTI to pregnant women
Delavirdine and efavirenz
| Teratogenic
152
Examples of NNRTI
Nevirapine, rilpivirine, efavirenze, delavirdine, etravirine
153
Efavirenze
Neuropsychiatric effects
154
Delavirdine and efavirenze
Teratogenic activity contraindicated in patients
155
Nevirapine (viramune)
For HIV AIDS
| Used in triplecombination due to viral resistance
156
Rilpivirine (edurant)
Second generation NNRTI
| Higher potency and longer half life and less side effects
157
Delavirdine (DLV, rescriptor)
Not HAART bc lower efficacy than other NNRTI. Associated with teratogenic effects and contraindicated in pregnancy
158
Efavirenz (EFV, sustiva)
Part of HAART
Also combined with other for prophylaxis of HIV transmission. Has dopaminergic and serotonergic activity, leading to neuropsychiatric adverse effects
159
What CNS effects do you get with efavirenz
Depression, anxiety, hallucinations, aggression, suicidal ideation, sleep disturbances)
160
How can you alleviate CNS side effects from efavirenz
Cyproheptadine
161
Etravirine (ETR, intelence)
Second generation NNRTI designed to be active against HIV with mutations that display resistance to the two most commmonly prescribed first generation NNRTI
162
NRTI (nucleoside reverse transcriptase inhibitors)
Antiretroviral drugs used for HIV work by competitively inhibiting nucleotide binding to reverse transcriptase, and also terminate the elongating DNA chain
163
Adverse
General prophylaxis and during pregnancy to decrease transmission
164
NRTI activation
Int he cel, requiring phosphorylation
165
Indication for NRTI
```
HIV
zidovudine (Zdz) for general prophylaxis and pregnant women to reduce transmission
```
166
MOA NRTI
1.activation in the cell by phosphorylation2.competitively inhibit nucleotide binding to reverse transcriptase, preventing the virus from making a DNA copy of its RNA
Chain termination
-lack of 3’-OH group in the incorporated nucleotide analogue prevents DNA chain elongation and therefore, the viral DNA growth is terminated
167
What are the two groups of NRTI
Nucleoside reverse transcriptase inhibitors
| Nucleotide reverse transcriptase inhibitors
168
Nucleoside reverse transcriptase inhibitors
```
Didanosine (DDI)
Emtricitabine (FTC)
Abacavir (ABC)
Lamivudine (3TC)
Stavudine (d4T)
Zidovudine (Zdv)
```
DEALSZ
169
Nucleoside analog medication
Tenofivir (TDF)
170
Didanosine DDI
Adenosine analog
171
Adverse reaction didanosine
Diarrhea, nausea, vomiting, abdominal pain, fever, headache rash, peripheral neuropathy
172
Emtricitabine (FTC)
Analog to cytidine
Treat HIV and hep B
Rare side effects-may get hepatotoxicity or lactic acidosis
173
Abacavir (ABC)
Nucleoside analog reverse transcriptase inhibitor analog of guanosine
Oral-high bioavailability
174
Side effects abacavir
Nausea, headache, fatigue, vomiting, hypersensitivity reaction, diarrhea, fever/chills , depression, rash , anziety, URI, ALT, AST up, hypertriglyceridemia, lipodystrophy
175
Lamivudine (3TC)
Cytidine analogue
| Inhibit HIV reverse transcriptase and hep b reverse transcriptase
176
Stavudine (d4T)
Thymidine analogue which inhibits HIV RT by competing with natural substrate, thymidine triphosphate. Then leads to termination of DNA replication by incorporating into the DNA strand
177
Side effects stavudine (d4T)
Peripheral neuropathy and lipodystrophy, so less commonly used in developing countries)
178
Zidovudine (Zdv)/AZt
For selectively inhibiting HIVs reverse transcriptase, the enzyme that the virus uses to make a DNA copy of its RNA.
179
Side effects zidovudine AZt
Anemia, neutropenia, hepatotoxicity, cardiomyopathy, myopathy
180
Why is AZt given as part of HAART
Resistance
181
Tenofovir
Nucleoside analogue reverts transcriptase inhibitor
| HIV hep b
182
Side effects tenofovir
Nausea, comiting, diarrhea, weakness
| Renal complications-acute renal failure, falcon I syndrome, proteinuria, tubular necrosis
183
NRTI toxicity
Medications that inhibit RT in HIV
184
Toxicities of NRTI
Bone marrow suppression, rash, neuropathy, lactic acidosis, pancreatitis, anemia
185
Which NRTI cause pancreatitis with alcohol
DIDANOSINE
186
How reverse bone marrow suppression with NRTI
G-CSF and erythropoietin
187
Cidofovir
Antiviral med for CMV retinitis in immunocompromised patients and is also indicated for acyclovir resistant HSV
188
MOA cidofovir
Long half life and works by preferentially inhibit viral DNA polymerase
Active and doesn’t require phosphorylation
189
Side effect cidofovir
Nephrotoxicity, which can be decreased when co administered with probenecid and IV saline
190
Indications cidofovir
CMV retinitis in immunocompromised patients
Acyclovir resistant HSV
191
MOA cidofovir
Inhibits viral DNA polymerase by selectively inhibiting viral DNA polymerases thus inhibiting viral DNA synthesis during its reproduction cycle
192
Side effects cidofovir
Nephrotoxicity
193
How prevent nephrotoxicity with cidofovir
Administer with probenecid and IV saline
194
HAART
Highly active antiretroviral therapy
Medication regime for patients who display AIDS defining lesions or have CD4 count below 350 internationally or 500 in US
195
What is HAART
2 NRTI+1 of the following: a NNRTI, a protease inhibitor or an integrate inhibitor
196
When initiate HAART
When HIV diagnosis
To reduce disease progression and prevent transmission
197
How many drugs are in HAART
3
198
What are the 2NRTIs(nucleoside reverse transcriptase inhibitors)
Inhibit binding of nucleotides to reverse transcriptase and by terminating the DNA chain
199
What is the 3rd HAART drug
```
NNRTI
Treats HIV by inhibiting nucleotide binding to reverse transcriptase at a different site of action than NRTI
Or
Protease inhibitor
Or
Integrate inhibitor
```
200
Ribavirin
Antiviral medication with activity against both RNA and DNA viruses.
201
Indication for ribavirin
Hep c and viral hemorrhagic fevers, off label RSV
202
Side effect ribavirin
Teratogen, hemolytic anemia
203
MOA ribavirin
Hypermutation in RNA viruses-incorporated into RNA base pairs guanine and adenosine. Induces hypermutations in RNA dependent replication, leading to virus death
Inhibits inosine monophosphate dehydrogenase-inhibits cellular inosine monophosphate dehydrogenase, depleting intracellular GTP which may play a role
204
Indications ribavirin
Hep c
Viral hemorrhagic fever
RSV
205
Side effects ribavirin
Hemolytic anemia
| Teratogen
206
Zanamivir (relenza) and oseltamivir (tamiflu)
Antiviral medications used to treat and provide prophylaxis against influenza A and B.
207
MOA zanamivir and oseltamivir
Bind to neuraminidase, preventing the virus from escaping its host cell and infecting others
208
Indications zanamivir and oseltamivir
Influenza a and b
Prophylaxis for people exposed to flu
209
MOA zanamivir and oseltamivir
Inhibits release of new virus 9render virus unable to escape from the host cell that it has infected. Thus unable to infect other cells)
Work to inhibit viral transmission by binding to the active site of viral neuraminidase. This makes the infected host cell unable to bud
