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Antivirals

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tapadebe's version from 2018-04-22 19:09

Section 1

Question Answer
-lovir DNA viruses
-ine, -mivir, -avir RNA viruses
tx of herpes, varicella and megalovirusacyclovir, ganciclovir, foscarnet, trifluridine, idoxuridine
tx of viral respiratory infections with what class?neuraminidase inhibitors: oseltamivir, and zanamivir.
oseltamivir and zanamiriv MOAneuraminidase inhibitors: inhibit neuraminidase and therefore decrease release of viral particles from cells to prevent spread of infection
neuraminidase inhibitors are active against what?influenza A and B; H1N1
oseltamivir is active against what?influenza A and B; H1N1
zanamivir is active against what?influenza A and B; H1N1
oseltamivir (class, effect, route)neuroaminidase inhibitor, oral; decreases duration of flu and decreases resp complications; prevent flu if taken 24-48 hours after exposure.
zanamivir (class, effect, route)neuroaminidase inhibitor, inhalation; decreases duration of flu and decreases resp complications; prevent flu if taken 24-48 hours after exposure.
peramivir (class, effect, route)neuroaminidae inhibitor, IV
side effects of zanamivirBRONCHOSPASM, skin rxns, renal and hepatic toxicity in all.
side effects of oseltamivirskin rxns, renal and hepatic toxicity in all, nausea, vomiting, headache
Acyclovir MOAguanine nucleoside analog; viral thymadine kinase phosphorylates the drug to produce acyclovir triphosphate; this gets incorporated into viral DNA and causes termination of DNA chain formation.
acyclovir treats what?herpes and varicella
acyclovir side effectsgi distress, headache, transient renal dysfunction
Ganciclovir MOAa guanine nucleoside analog; competitively inhibits viral dna polymerase terminating DNA synthesis
ganciclovir treatsCMV retinitis
Ganciclovir side effectsmyelosuppression, dose dependent neutropenia, CNS effects, CARCINOGENIC
foscarnet MOApyrophosphate analog; inhibits viral DNA and RNA polymerases so inhibits RNA and DNA synthesis.
foscarnet treats what?treats herpes in those resistant to acyclovir; treats CMV in those resistant to ganciclovir
foscarnet adverse effectsMORE THAN WITH ganciclivor and acyclovir; NEPHROTOXICITY, anemia, fever, GENITAL ULCERATION, electrolyte abnormalities
trifluoridine and idoxuridine MOAinhibits viral dna synthesis
trifluoridine treats what?keratoconjunctivitis and epithelial keratitis from herpes infection
idoxuridine treats what?topical for herpes keratitis
trifluridine adverse effectinflammation of the cornea
idoxuridine adverse effecteye pain and edema
what is used to treat viral hepatic infectionsinterferon alpha and ribavirin
interferon alpha MOAmade naturally in body in response to viral infections; binds to cellular receptors and activates the JAK-STAT pathway which induces proteins that enhance our immune system and inhibit viral protein synthesis
interferon alpha is used to treat what?genital warts, hep B and C, kaposi sarcoma and multiple sclerosis
interferon toxicity?flu like symptoms; dose limiting bone marrow suppression, increased susceptibility to infections, anorexia, depression, anxiety.
Ribavirin MOAguanosine analog; inhibits viral mRNA synthesis.
ribavirin used to treat what?with interferon tx Hep C; Tx RSV, influenza A and B, arenoviruses, HIV.
ribavirin given how? oral, IV?ribavirin is given as aerosol
adverse effects ribavirinbone marrow suppression, anemia, wheezing, TERATOGENIC--do not give to pregnant women.
Nucleoside reverse transcriptase inhibitors are:zidovudine, didanosine, stavudine, lamivudine, ABACAVIR, zalcitabine.
zalcitabine is a nucleoside reverse transcriptase inhibitor.
MOA zidovudinemammilian hymidine kinase converts the drug to zidovudine triphosphate which is incorporated into viral DNA, blocking reverse transcriptase and preventing rna and dna replication.
Zidovudine is unique becausedrug most frequently given to treat HIV; and it protects fetuses from being infected in HIV infected pregnant women.
how does resistance develop to NRTIs?reverse transcriptase becomes mutated and no longer has affinity for the drugs.
zidovudine main adverse effect??bone marrow problems- anemia and leukopenia; hyperlipidemia, headaches
didanosine drug class?nucleoside reverse transcriptase inhibitor
didanosine used for who? when?when HIV patients become resistant to zidovudine.
adverse effect of didanosine?FATAL PANCREATITIS (didanosine = dad); dose limiting peripheral neuropathy
drugs causing peripheral neuropathydidanosine, stavudine and zalcitibine.
side effects of stavudinePERIPHERAL NEUROPATHY; fatal lactic acidosis (stav = stab= pain =lactic acid pain= lactic acidosis) hyperlipidemia
lamivudine treats HIV and what?chronic hep B
adverse effect of lamivudine?pancreatitis in young patients.
abacavir is given in combo with what two drugszidovudine and lamivudine
abacavir is what type of druga nucleoside reverse transcriptase inhibitor like zidovudine, lamivudine, etc.
Abacavir side effectshypersensitivity--fever, GI distress, rash.
zalcitibineused with zidovudine or for those that develop resistance to zidovudine
toxicity of zalcitibine??peripheral neuropathy and rash.
tenofovirnucleotide reverse transcriptase inhibitor
tenofovir used to treat what? treats HIV and chronic hep B. (like lamivudine)
adverse effects of tenofovirFLATULENCE and some renal toxicity;
benefit of tenofovir?can be given prophylactically to reduce chances of contracting HIV if have been exposed.
do not give tenofovir with which drugs?didanosine, lamivudine or abacavir.
non-nucleoside reverse transcriptase inhibitorsefavirenz, nevirapine, delavirdine
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Section 2