Antiviral

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Author:
lazzsant
ID:
112911
Filename:
Antiviral
Updated:
2011-10-28 22:06:33
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Antiviral
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Antiviral
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  1. NRTI drugs
    • Abacavir
    • Didanosine
    • Emtricitabine
    • Lamivudine
    • Stavudine
    • Zidovudine
  2. NNRTI
    • Delavirdine
    • Efavirenz
    • Nevirapine
  3. Protease inhibitors
    • Atazanavir
    • Indinavir
    • Lopinavir
    • Ritonavir
    • Saquinavir
  4. Entry Inhibitors
    • Enfuvirtide
    • Maraviroc
  5. Integrase Inhibitors
    Raltegravir
  6. Nucleotide Reverse transcriptase inhibitors
    MOA

    CLINICAL

    A/E
    • competitive inhibition of HIV-1 reverse transcriptase
    • Incorporation into viral DNA chain -> premature chain termination.

    HIV 1/2

    Mitochondrial toxicity
  7. Abacavir
    NRTI

    • Guanosine analog
    • Oral
    • Resistance needs 2-3 mutations

    A/E: hypersensitivity reactions
  8. Didanosine
    • NRTI
    • Deoxyadenosine synthetic analog
    • Oral (empty stomach)

    A/E: Pancreatitis, neuropathy, cardiomyopathy, retinal changes***

    CONTRA: with indinavir, delavirdane, atazanavir, dapsone, itraconazole, & fluoroquinolone
  9. Emtricitabine
    • NRTI
    • Fluorinated analog of Lamivudine
    • ORAL
    • Spectrum: HIV & HBV

    Contra: Kids, pregnancy, renal failure, hepatic failure, with metronidazole disulfira or lamivudine
  10. Lamivudine
    • NRTI
    • Cytosine analog
    • ORAL
    • Spectrum: HIV-1, HBV

    MOA: inhibits HIV reverse transcriptase and HBV DNA polymerase

    CONTRA: with zalcitabine
  11. Stavudine
    • NRTI
    • Thymidine analog
    • ORAL

    A/E: neuropathy, panreatitis, arthralgias.

    • CONTRA: Advanced immunosuppression.
    • With neuropathy-inducing drugs
  12. Zidovudine
    • NRTI
    • Deoxythymidine analog

    • CLINICAL:
    • Prevent HIV vertical transmission
    • Occupational HIV
  13. NNRTI
    MOA: Bind HIV-1 reverse transcriptase in an allosteric fashion.

    A/E: Steven Johnsons syndrome

    • CONTRA:
    • Not with: Anti-arrhythmics
    • antihistamines
    • sedative hypnotics
    • Neuroleptics
    • Ergot alkaloid derivatives
    • HMG COA reductase inhibitors
    • Anticonvulsants
    • Oral contraceptives
  14. Delvaridine
    • NNRTI
    • ORAL

    CONTRA: pregnancy
  15. Efavirenz
    ORAL (empty stomach)

    • CONTRA:
    • High fat meals
    • Pregnancy
  16. Nevirapine
    • NNRTI
    • ORAL

    Clincal: HIV vertical transmission
  17. PI
    MOA: prevent posttranslational cleavage of Gag-Pol polyprotein -> immature viral particles

    • A/E: Cushing like fat redistribution
    • inc LDL and trigylceride levels
  18. Atazanavir
    • PI
    • ORAL

    • Contra:
    • with acid-reducing agents
    • with indinavir, irinotecan, tenofovir, and efavirenz
  19. Indinavir
    • PI
    • Oral (empty stomach)

    • A/E: indirect hyperbilirubinemia and nephrolithiasis
    • Thrombocytopenia
  20. Lopinavir
    • PI
    • Oral with ritonavir (inhibits CYP3A metabolism of lopinavir)
  21. Rotinavir
    • PI
    • Oral

    A/E: paresthesias, elevated aminotransferase levels

    • Contra: impaired hepatic function
    • with digoxin and theophylline
  22. Saquinavir
    • PI
    • Oral(with ritonavir, 2 hours after fatty meal)
  23. Enfuvirtide
    Entry inhibitor

    Spectrum: HIV 1

    MOA: bind gp 41 (mutation)

    A/E: hypersensitivity, inc risk of bacterial pneumonia
  24. Maraviroc
    Entry inhibitor

    Oral

    Spectrum: R5 HIV-1

    • MOA: bind CCR5
    • Mutation: in V3 loop of gp 120

    Last drive drug
  25. Raltegrvir
    • Integrase inhibitor
    • ORAL

    Spectrum: HIV1/2

    MOA: binds integrase (mutation)

    Clinical: treatment experienced patients as last resort

    Contra: with rifampin and antacids

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