Pharm Test 3: Viruses & Antiviral Drugs
Card Set Information
Pharm Test 3: Viruses & Antiviral Drugs
Viruses Antiviral Drugs
Viruses & Antiviral Drugs
4 Drugs that block viral entry and attachment
Enfuvirtide (HIV), Maraviroc (HIV), Docosanol (HSV), Palivizumab (RSV)
Herpesviruses (HSV, VZV, CMV) have what type of genetic material?
Retroviruses (HIV) have what type of genetic material?
Orthomyxoviruses (Influenza A, B) have what type of genetic material?
Hepadnaviruses (HBV, HCV) have what type of genetic material?
HBV, HCV (Hep B & C)
Includes watery blisters in the skin or mucous membranes of the mouth, lips, or genitals
HSV-1 and HSV-2
Acyclovir is most effective against
HSV (Herpes Simplex Virus)
Why is CMV resistant to Acyclovir?
It lacks a thymidine kinase or is the virally encoded thymidine phosphate is unable to phosphorylate acyclovir.
Name 3 prodrugs
Valacyclovir, Penciclovir, Famciclovir
Acylovir molecules entering the cell are converted to? By?
By virus-induced thymidine kinase
(Host cell enzymes add 2 more phosphates. Acyclovir triphosphate is them transported to the nucleus)
Acyclovir monophosphate takes the place of _______ in the viral DNA. It stops chain elongation because it lacks _____
Major adverse drug rxn of Acyclovir
Reversible renal toxicity
Neurologic effects (tremors, delirium, seizures)
Acyclovir resistant mutants are sensitive to _____ because they do not require viral ______ for activation.
Ganciclovir is much more effective against ____ than acyclovir
Adverse drug rxn w/ Ganciclovir
CNS toxicity (can cause myelosuppression)
What drug can cause myelosuppression (particularly after IV adminstration)
Myelosuppression of Ganciclovir (CMV) may be additive in patients receiving concurrent ?
Primary drugs for Influenza A? How do they work?
Prevent RNA uncoating and thus release of genetic material
Which two drugs are used to treat Influenza A & B?
Which drug inhibits RNA polymerase of the influenza virus?
Analogs of sialic acid
Tricyclic amines of adamantane
GI and CNS are more likely to occur in? (Rimantadine or Amantadine)
Which drug is not recommended for patients with underlying airway disease?
Resistance to oseltamivir may be associated w/ point mutations in the viral ____ or ____ genes.
Viral point mutations in hemagglutinin or neuramindiase and provide resistance to
In contrast, to the tx of patients w/ chonric HBV infection, the primary goal of tx in patients with HCV infection is _____
Goal of HBV therapy
Sustain suppression (prevent complications, slow progression of hepatic disease, reduce the need for liver transplantation)
Major mechanism of action of IFN-a
Inhibition of translation
What is the most powerful tx against HBV and C?
IFN-a (antiviral properties)
What drug should not be administered w/
IFN-a, because of risk of hepatic failure
IFN-a potential drug-drug interactions
Theophylline and methadone levels may be increased
Two drugs used in combination with IFN-a
Lamivudine (HBV)- also used to treat HIV
Lamivudine w/ coinfection w/ HIV increase the risk of
Name 2 Entry Inhibitors
Binds specifically and slectively to host protein CCR5. Treats HIV-1 infection in those who are experiencing virological failure due to resistance to other antiretroviral
Maraviroc binds to ___ and treats____
CCR5, HIV-1 infxn that exhivits resistance to other antiretrovirals
Resitance to what drug is associated w/ one or more mutations in the V3 loop of gp120?
Maraviroc is contraindicated in pts. w/ ?
Severe or end-stage renal impairment who are taking concurrent CYP3A inhibitors or inducers
Pts. w/ increased cardiovascular risk (has been known to cause myocardial ischemia/infarction)
1st drug to be approved, well absorbed and distributed to most tissues (including CSF)
Zidovine (Nucleoside and Nucleotide Reverse Transcriptase Inhibitor)
Nucleoside and Nucleotide Reverse Transcriptase Inhibitor
Non-Nucleoside and Nucleotide Reverse Transcriptase Inhibitors
Delavirdine, Etravirine, and Nevirapine
Delavirdine, Etravirine and Nevirapine treat? How?
Treat HiV-1 by binding directly to HIV-1 reverse transcriptase and result in allosteric inhibition of RNA- and DNA- dependent DNA polymerase activity
Drug that binds directely to HIV-1 reverse transcriptase and is contraindicated in pregnancy
Drug that binds directely to HIV-1 reverse transcriptase and can also cause an elevation in serum cholesterol, tiglyceride, and glucose?
Which drug has a minimal effect on serum lipids?
Which Non-Nucleoside and Nucleotide Reverse Transcriptase Inhibitors are extensively metabolized by the CYP3A and CYP2D6 enzymes. It also inhibits CYP3A4 and 2C9
Which Non-Nucleoside and Nucleotide Reverse Transcriptase Inhibitors is a substrate as well as an inducer of CYP3A4 and an inhibitor of CYP2C9 and CYP2C19?
Results in decreased levels of methadone and indinavir
Inhibits viral integrase enzyme that is essential for replication of HIV-1, -2
In combination w/ rifampin, a strong inducer of ____________, the dose of ________ should be increased from 400 to 800 mg twice daily.
UDP-glucuronosyl transferase 1A1 (UGT1A1)