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HLSC 220 Pharmacotherapeutics for Health Professionals 💊 > Treatment of Viral Infections - Ch. 97 & 98 > Flashcards

Treatment of Viral Infections - Ch. 97 & 98 Flashcards

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1
Q

What are viruses?

A

Tiny microorganisms that infect and replicate insiede host cells

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2
Q

What is SARS CoV -2?

A

Virus = Severe acute respirotory syndrome coronavirus 2

Disease is called Coronavirus disease (COVID-19)

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3
Q

What are some problems associated with viral treatments?

A

Viruses are difficult to kill because they live inside host cells
- any drug that kills a virus may also kill cells

Viral infections are often initially asymptomatic
- delay of treatment until infection is well established (extensive replication)

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4
Q

What is the best response to viral infections?

A

Competent immune system
-Good immune system with eliminate/destroy virus replication

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5
Q

A healthy immune system works _______________ with the drug to eliminate or suppress viral activity

A

Synergistically

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6
Q

Who has frequent viral infections?

A

Immunocomprimised patients
-Cancer pt. leukemia, lymphoma
-Transplant pt. (immunosuppressants)!!!
-AIDS (attacks immune system)

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7
Q

How do most antiviral drugs work?

A

Inhibit replication of the virus inside the host cell
-Doesn’t directly destroy mature virions

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8
Q

What viruses are controlled by current antiviral therapy?

A

Cytomegalovirus (CMV)
Hepatitis virus
Herpes virus
Human immunodeficiency virus (HIV)
Influenza virus (Flu)
Respiratory syncytial virus (RSV)

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9
Q

What are the 2 families of antiviral medications?

A

Antiretroviral drugs
Antiviral drugs

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10
Q

What are antiretrovirals used to treat?

A

infections caused by HIV, the virus that causes AIDS

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11
Q

What are antivirals used to treat?

A

Infections caused by viruses

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12
Q

HIV is a member of which family?

A

Retroviruses
-Host cells turn DNA into RNA
retroviruses reverse it

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13
Q

HIV is a virus that leads to what syndrome?

A

Aquired immunodeficiency syndrome (AIDS)

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14
Q

How is HIV transmitted?

A

Sexual activity
Intravenous drug use
Mother to fetus

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15
Q

Whata re the 5 oppurtunist infections seen in HIV-infected patients?

A

Protozoal
Fungal
Viral
Bacterial
Oppurtunistic neoplasias

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16
Q

What are protozoal opportunistic infections?

A

Toxoplasmosis of the brain, others

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17
Q

What are fungal opportunistic infections?

A

Candidiasis of lungs, esophagus, trachea
Pneumocystis jirovecii pneuomonia, others

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18
Q

What are viral opportunistic infections?

A

CMV, HSV, others

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19
Q

What are bacterial opportunistic infections?

A

Various mycobacterial infections, others
Extra pulmonary tuberculosis (TB)

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20
Q

What are Opportunistic neoplasias?

A

Kaposi’s sarcoma, others

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21
Q

What are the 3 focused groups of antivirals for HIV (antiretrovirals)?

A

Reverse transcriptase inhibitors
Protease Inhibitors
Integrase inhibitors

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22
Q

How do Reverse transcriptase inhibitors (RTIs) work?

A

Block activity of the enzyme reverse transcriptase and prevents production of new DNA from viral RNA

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23
Q

Whata re the subclasses of RTIs?

A

Nucleoside RTIs (NRTIs)
Non-nuceloside RTIs (NNRTIs)

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24
Q

What do NRTIs do?

A

Competes with cell nucelosides for DNA syntehsis

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25
Example of NRTI?
Zidovudine (AZT: Azidothymidine)
26
What is the major adverse effect associated with NRTIs?
Bone marrow supression -anemia and neutropenia
27
How do Protease inhbitors (PIs) work?
Inhbit the retroviral protease enzyme which prevents viral protein preparation
28
What adverse effects are associated with PIs? (protease inhibitors)
Hyperglycemia, new/exacerbate diabetes
29
What are some examples of protease inhibitors?
!! Ritonavir atazanavir sulfate fosamprenavir indinavir nelfinavir
30
Ritonavir has many what?
Drug-drug interactions CYP450 inhibitor and inducer
31
What is the full name for integrase inhibitors?
HIV integrase strand transfer inhibitors (INSTIs)
32
How do INSTIs work?
Inhbits insertion of HIV DNA into CD4 (T-helper) cell DNA
33
Examples of INSTIs?
Raltegravir Dolutegravir Bictegravir Elvitegravir
34
What is essential for HIV treatment?
Combination therapy
35
What is the name of anti-viral therapy used to treat HIV?
Highly active antiretroviral therapy (HAART)
36
What is the goal of HAART?
Reduce HIV in plasma - viral load = no AIDS development = cannot pass virus to other people
37
What are some HIV anti-viral drug combos?
2 NRTIs + 1 NNRTI 2 NRTIs + 1 or 2 Protease inhibitors BIKTARVY bictegravir/emtricitabine/tenofovir alafenamide
38
What is BIKTARVY?
Single tab treatment of HIV-1 infection (Aug 2018) Intergrase inhibitor + 2 NRTIs
39
What is taken to prevent acquisition of HIV infection by uninfected persons?
Pre-exposure Prophylaxis (PrEP) as a daily drug regime
40
What is Pre-exposure Prophylaxis (PrEP)?
Tenofovir and emtricitabine 2 rti combination
41
What is taken very soon after possible exposure to HIV?
Post-exposure Prophylaxis (PEP)
42
When can you start PEP?
Within 3 days -Lasts 28 days
43
Example of PEP drugs?
Raltegravir + tenofovir + emtricitabine
44
What are the types of influenza virus?
A (~96%) B C
45
Which influenza virus has less severe symptoms?
Influenza C
46
What does influenza A have on the surface of its virus?
H and N surface proteins e.g, H1N1, H3N2
47
What are the different kinds of Hepatitis viruses?
A, B, C, D, E, G
48
What viruses belong to the Herpesvirus group?
Varicella zoster virus Herpes simplex viruses Cytomegalovirus
49
What viruses are part of Varicella zoster?
Varicella = Chickenpox Herpes Zoster = Shingles
50
What are the first two kinds of herpes?
HSV-1 = oral herpes HSV-2 = genital herpes
51
What antivirals are used for influenza?
Neuraminidase inhibitors
52
How do neuraminidase inhibitors work?
Prevents realse of virus from host cell
53
Examples of neuraminidase inhbitor drugs?
Oseltamivir (Tamiflu) zanamivir
54
Oseltamivir (Tamiflu) is active against which types of influenza?
influenza A and B virus
55
What adverse effects are associated with Oseltamivir (Tamiflu)?
GI disturbances -nausea, vomiting, diarrhea
56
Treatment of influenza should being within what?
2 days of influenza symptom onset
57
When can neuraminidase inhibitors be used prophylactically?
When vaccination is not possible or in early stages of infection
58
Neuraminidase inhibitors were stock piled to use during what?
Swine (H1N1) flu
59
Neuraminidase inhibitors can reduce what when used therapeutically?
Recovery time
60
What is a newer flu drug?
Baloxavir -Single dose regime
61
Baloxavir has equal effectiveness to which drug?
Oseltamivir
62
What drugs are used for Herpes virus (VZV and HSV)?
DNA polymerase inhibitors
63
How do DNA polymerase inhibitors work?
Act as synthetic nucleoside analogues which stops viral DNA syntehsis
64
Example of DNA polymerase inhbitor drug used to treat herpes virus?
Acyclovir (Zovirax)
65
What is Acyclovir used for?
Suppress replication of Herpes (HSV-1, HSV-2, VZV) -For treatment of initial and recurrent episodes of these infections
66
What are the available forms of acyclovir?
Oral Topical Parenteral
67
What is Cytomegalovirus (CMV)?
Member of herpes virus family Many have the virus but don't show symptoms
68
How is cytomegalovirus spread?
Bodily fluids -high risk in immunocomprimised patients
69
What drugs are used for cytomegalovirus (CMV)?
DNA Polymerase inhibitors
70
Exampels of DNA polymerase inhibitors used to treat CMV?
Ganciclovir
71
What can ganciclovir affect?
Brain, eye, lung and GI tract
72
Ganciclover is used to treat CMV ________?
CMV retinitis -Ophthalmic form surgically implanted
73
What are the available forms of Ganciclovir?
Oral Parenteral
74
What antiviral DNA polymerase inhibitor is used to treat respiratory syncytial virus (RSV) and hepatitis C?
Ribavirin (mechanism unclear)
75
How is Ribavirin administered?
PO or nasal inhalation
76
Which patients is Ribavirin nasal inhalation used?
Hospitalized infants with RSV

HLSC 220 Pharmacotherapeutics for Health Professionals 💊 (31 decks)

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