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Usmle 1 Microbiology > Virus - Antiviral agents > Flashcards

Virus - Antiviral agents Flashcards

1
Q

Acyclovir and valacyclovir

The mechanism of action (MOA)

A

MOA: guanosine analog; activated by herpes thymidine kinase → inhibits viral DNA polymerase

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2
Q

Acyclovir and valacyclovir

Indication(s) (IND)

A

IND: HSV (treatment and prophylaxis for oral, genital, and ocular herpes), VZV (chickenpox and shingles)

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3
Q

Acyclovir and valacyclovir

. Significant side effects and uniquetoxicity (TOX)

A

TOX: neurotoxic (delirium and tremors) and nephrotoxic

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4
Q

Ganciclovir

The mechanism of action (MOA)

A

MOA: guanosine analog; activated by human thymidine kinase → inhibits CMV DNA polymerase

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5
Q

Ganciclovir

Indication(s) (IND)

A

IND: CMV (retinitis, pneumonia, colitis), especially in immunocompromised people

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6
Q

Ganciclovir

Significant side effects and uniquetoxicity (TOX)

A

TOX: bone marrow suppression, nephrotoxic, and ↓ spermatogenesis (toxicity → acyclovir because activated by human enzyme)

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7
Q

Foscarnet

The mechanism of action (MOA)

A

MOA: pyrophosphate analog; inhibits viral DNA polymerase (no activation required)

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8
Q

Foscarnet

Indication(s) (IND)

A

IND: CMV, HSV (refractory infections)

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9
Q

Foscarnet

Significant side effects and uniquetoxicity (TOX)

A

TOX: reversible nephrotoxicity and anemia

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10
Q

Nucleoside RT inhibitors (zidovudine—azidothymidine [AZT], didanosine—ddl, zalcitabine—ddC, lamivudine-3TC, and stavudine—d4T)
The mechanism of action (MOA)

A

MOA: nucleoside analogs; activated by phosphorylation → inhibits RT → prevents incorporation of viral genome into host DNA

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11
Q

Nucleoside RT inhibitors (zidovudine—azidothymidine [AZT], didanosine—ddl, zalcitabine—ddC, lamivudine-3TC, and stavudine—d4T)
Indication(s) (IND)

A

IND: part of combination therapy for HIV

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12
Q

Nucleoside RT inhibitors (zidovudine—azidothymidine [AZT], didanosine—ddl, zalcitabine—ddC, lamivudine-3TC, and stavudine—d4T)
Significant side effects and uniquetoxicity (TOX)

A

TOX: bone marrow suppression, peripheral neuropathy, pancreatitis (especially ddl), lactic acidosis, and macrocytic anemia (AZT)

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13
Q

Nonnucleoside RT inhibitors (nevirapine, delavirdine, and efavirenz)
The mechanism of action (MOA)

A

MOA: binds directly to and inhibits HIV RT → prevents incorporation of viral genome into host DNA

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14
Q

Nonnucleoside RT inhibitors (nevirapine, delavirdine, and efavirenz)
Indication(s) (IND)

A

IND: part of combination therapy for HIV

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15
Q

Nonnucleoside RT inhibitors (nevirapine, delavirdine, and efavirenz)
Significant side effects and uniquetoxicity (TOX)

A

TOX: rash (including Steven-Johnson), ↑ liver enzymes, inhibits P-450, vivid dreams/CNS changes (with ef avirenz)

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16
Q 
Protease inhibitors (saquinavir, ritonavir, indinavir, nelf inavir, and amprenavir) 
 The mechanism of action (MOA)
A

MOA: blocks protease enzyme → inhibits assembly of viral core and new viruses

17
Q 
Protease inhibitors (saquinavir, ritonavir, indinavir, nelf inavir, and amprenavir) 
 Indication(s) (IND)
A

IND: part of combination therapy for HIV

18
Q 
Protease inhibitors (saquinavir, ritonavir, indinavir, nelf inavir, and amprenavir) 
Significant side effects and uniquetoxicity (TOX)
A

TOX: GI upset, insulin resistance, ↑ lipids, fat redistribution syndromes, interstitial nephritis, and thrombocytopenia (indinavir)

19
Q

Amantadine and rimantadine

The mechanism of action (MOA)

A

MOA: inhibits viral penetration and uncoating; releases dopamine (DA) from intact nerve terminals

20
Q

Amantadine and rimantadine

Indication(s) (IND)

A

IND: influenza A treatment/prophylaxis, Parkinson disease

21
Q

Amantadine and rimantadine

Significant side effects and uniquetoxicity (TOX)

A

TOX: CNS effects: confusion, ataxia, and slurred speech (less with rimantadine); teratogenesis

22
Q

Zanamivir and oseltamivir

The mechanism of action (MOA)

A

MOA: neuraminidase inhibitor → alters virion aggregation and release

23
Q

Zanamivir and oseltamivir

Indication(s) (IND)

A

IND: influenza A and B treatment and prophylaxis (oseltamivir)

24
Q

Zanamivir and oseltamivir

Significant side effects and uniquetoxicity (TOX)

A

TOX: bronchospasm in patients with asthma /COPD) (zanamivir)

25
Q

Ribavirin

The mechanism of action (MOA)

A

MOA: guanosine analog; activated by phosphorylation → inhibits inosine-5’-monophosphate (IMP) dehydrogenase

26
Q

Ribavirin

Indication(s) (IND)

A

IND: RSV, hantavirus, and chronic hepatitis C

27
Q

Ribavirin

Significant side effects and uniquetoxicity (TOX)

A

TOX: hemolysis (when given IV)

28
Q

Interferon-α

The mechanism of action (MOA)

A

MOA: human glycoproteins that interfere with ability of viruses to replicate (block protein synthesis and degrade mRNA)

29
Q

Interferon-α

Indication(s) (IND)

A

IND: chronic hepatitis B and C, genital warts, Kaposi sarcoma, and hairy cell leukemia

30
Q

Interferon-α

Significant side effects and uniquetoxicity (TOX)

A

TOX: bone marrow suppression

31
Q

What constitutes highly active antiretroviral therapy (HAART)?

A

Two nucleoside RT inhibitors and a protease inhibitor or nonnucleoside RT inhibitor. Note: no patient should ever be on monotherapy as resistance is invariable.

32
Q

When is HAART typically initiated?

A

CD4+ 500 cells/mL or very high viral load

33
Q

Which drug is used to prevent vertical transmission during pregnancy?

A

Zidovudine (AZT)

Usmle 1 Microbiology (15 decks)

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