Antiviral Agents II

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HUSOP2014
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136867
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Antiviral Agents II
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2012-02-22 07:37:06
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HUSOP DA EXAM2 Antiviral II
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  1. __________ is an inorganic pyrophosphate that inhibits all HSV and HIV.
    Foscarnet
  2. Foscarnet is effective against _____ _____ CMV and _____ _____ HSV and VZV strains.
    ganciclovir-resistant, acyclovir-resistant
  3. What is foscarnet's MOA?
    It reversibly blocks the pyrophosphate binding site of viral polymerase non-competitively. This inhibits cleavage of pyrophosphate from dNTP's.
  4. Resistance to foscarnet occurs through _____ _____ in the viral polymerase gene.
    point mutations
  5. Foscarnet use can cause chronic __________. This leads to significant CNS disturbances like tremors and seizures.
    hypocalcemia
  6. Which of the following is not an indication for foscarnet?
    A. Ganciclovir-resistant CMV retinitis
    B. Acyclovir-resistant HSV infections
    C. Zidovudine-resistant HIV
    D. Prophylaxis for bone marrow transplants
    C
  7. __________ is an acyclic guanine nucleoside, similiar to acyclovir.
    Ganciclovir
  8. What is ganciclovir's prodrug form?
    Valganciclovir-L-valyl ester
  9. What infection is ganciclovir particularly effective against?
    CMV
  10. During HSV infection ganciclovir is initially phosphorylated by virally encoded _____ _____. A viral__________ phosphorylates it during CMV infection.
    thymidine kinase, phosphotransferase
  11. The di- and triphosphate forms of ganciclovir are phosphorylated by _____ _____.
    cellular enzymes
  12. The triphosphate form of ganciclovir is a competitive inhibitor for _____ at the viral DNA polymerase.
    dGTP
  13. What happens when ganciclovir is incorporated into viral DNA?
    It halts elongation.
  14. How does viral resistance develop to ganciclovir?
    Decreased phosphorylation due to mutations in the viral phosphotransferase gene and mutations in the viral DNA polymerase gene.
  15. T/F Ganciclovir is more effective in acyclovir-resistant HSV.
    False
  16. T/F Food increases Valganciclovir's bioavailabilty.
    True
  17. What is the primary dose-limiting ADR for ganciclovir?
    Myelosuppression- neutropenia and thrombocytopenia
  18. How does one treat ganciclovir-induced neutropenia?
    A recombinant granulocyte colony stimulating factor.
  19. Ganciclovir is used to treat CMV infections particularly in _____ _____.
    immunosuppressed patients
  20. Which drug is only available as a DMSO formulation for topical treatment of herpes labialis, genitalis, and zoster?
    Idoxuridine
  21. What fluorinated nucleoside has limited use in the USA in treating keratoconjunctivitis?
    trifluridine
  22. The hepatitis B virus has dsDNA, but works through an RNA intermediate with _____ _____.
    Reverse transcriptase
  23. _____ _____ & _____ are general types of agents that treat HBV and HCV infections.
    Nucleotide analogs, interferons
  24. _____ is an acyclic phosphate nucleotide analogue of adenosine monophosphate.
    Adefovir
  25. What is the diester prodrug of adefovir?
    Adefovir dipivoxil
  26. The __________ of adefovir is a competitive inhibitor at viral _____ _____ and _____ _____ for dATP.
    DNA polymerase, reverse transcriptase
  27. If adefovir is incorporated into the viral DNA, it acts as a _____ _____.
    Chain terminator
  28. What is the most notable ADR with adefovir dipivoxil use?
    Nephrotoxicity and tubular dysfunction
  29. Other than chronic HBV infection, adefovir is effective in treating _____ _____ HBV infections.
    lamivudine-resistant
  30. __________ are non-glycosylated, recombinant proteins that inhibit animal viruses.
    Interferons
  31. Interferon binding to its receptor activates which pathway leading to expression of proteins influencing viral replication?
    JAK/STAT
  32. Describe the several effects of interferon therapy.
    Transcription inhibition, translation inhibition, protein processing inhibition, and virus maturation inhibition
  33. T/F Interferons must be given IV.
    False, IM or Sub-Q
  34. __________ increases blood levels and duration of interferons.
    Pegylation
  35. Injection of interferons can cause an _____ _____ syndrome with fever, chills, headache, and myalgia.
    influenza-like
  36. T/F Interferon therapy clears HCV infections better than HBV infections when used as monotherapy.
    False, 1/3 of HBV patients see viral load clearance, but HCV is generally not cleared.
  37. Lamivudine inhibits HBV _____ _____, leading to _____ _____.
    DNA polymerase, chain termination
  38. Lamivudine is commonly used with _____ or _____ to treat hepadnaviruses.
    Adefovir, penciclovir
  39. _____ is a purine nucleoside analog that inhibits a wide variety of DNA and RNA viruses.
    Ribavirin
  40. What is ribavirin's MOA?
    Generally unclear, but it seems to alter intracellular nucleotide pools with inhibition of viral mRNA synthesis. It also inhibits GTP-dependent 5' capping of mRNA.
  41. Ribavirin is indicated for _____ infections.
    HCV
  42. Ribavirin is administered with ___________ for standard treatment of _____.
    Pegylated interferon a2a and a2b, HCV

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