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38 Cards in this Set

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acyclovir
nucleoside analog

converted to NuMP by viral thymidine kinase (infected cells only)

NuTP is a chain terminator

valacyclovir is prodrug that is better absorbed orally and can be given 3/day instead of 5/day

USES:
genital herpes (HSV)
herpes simples (HSV)


DRUG OF CHOICE FOR GENITAL HERPES (and herpes zoster, they're the same drugs): valaciclovir, acyclovir, and famiciclovir

DRUG OF CHOICE FOR NEONATAL HERPES: acyclovir (IV)

acyclovir is DRUG OF CHOICE FOR HERPES ENCEPHALITIS (even though vidarabine is the only one not approved)
what are the T4+ cell levels to begin treatment of HIV patient
symptomatic - treat
>350 dont treat
<200 treat
200-350 = grey area
interferon alpha-2a
viral transcription inhibitor

USES:
Hepatitis B
Hepatitis C (IFN alpha2 + ribavirin) - this is the only Rx recommended

s/e:
depression and flu-like syndrome

"feel like shit and depressed"
peginterferon alpha-2b
viral transcription inhibitor

polyethylene glycol increases its half life
inhibits viral transcription

USES:
Hepatitis B
Hepatitis C (IFN alpha2 + ribavirin)

s/e:
depression and flu-like syndrome
saquinavir
PI -

avoid the hard gel capsule as single PI
zalcitabine
zal is a NRTI to be taken off the market because it is not very potent and sucks really bad
atazanavir + indinavir?
Artificial intelligence = hyperbilirubinemia
amantandine
uncoating inhibitor (man in a coat)

inhbits viral uncoating
works only on Influenza type A (M2 ion channel)
rimantadine
uncoating inhibitor (man in a coat)

inhbits viral uncoating
works only on Influenza type A (M2 ion channel)

amantadine and rimantadine - very similar
fomivirsen
intraocular antiviral for CMV

antisense (german) oligo that inhibits translation

USES:
CMV retinitis (AIDS patients)
vidarabine
nucleoside analog

topically: herpes keratitis or conjunctivitis

DRUG OF CHOICE FOR HERPES KERATITIS: vidarabine, idoxurine, trifluridine

IV: herpes encephalitis (acyclovir works better)
penciclovir
nucleoside analog

activated by thymidine kinased (like acyclovir) so selective

cream: oral herpes simplex (cold sores)

DRUG OF CHOICE FOR ORAL HERPES: pen and fam
famiclovir
nucleoside analog. prodrug of penciclovir.

activated by thymidine kinase so it's selective.



Use: herpes simplex (I'm not a fam of cold sores)

DRUG OF CHOICE FOR ORAL HERPES: pen and fam

DRUG OF CHOICE FOR GENITAL HERPES (and herpes zoster, they're the same drugs): valaciclovir, acyclovir, and famiciclovir
trifluridine
ophthalmic antiviral for HSV keratitis


DRUG OF CHOICE FOR HERPES KERATITIS: vidarabine, idoxurine, trifluridine
idoxurine
ophthalmic antiviral for HSV keratitis


DRUG OF CHOICE FOR HERPES KERATITIS: vidarabine, idoxurine, trifluridine
ganciclovir
inhibits CMV polymerase (comp inhib for active site)

converted to Ganciclovir-MP by UL97 (CMV enzyme)

S/E:
bone marrow suppression

prodrug: valciclovir (can give orally instead of IV)

drugs for CMV: ganciclovir, valganciclovir, foscarnet, cidofovir, fomivirsen
foscarnet
pyrophosphate analog
*doesnt have to be phosphorylated to be activated*


competitively inhibits herpesvirus family DNA pol

USE: CMV retinitis

***s/E (3):
1. nephrotoxic (think renal transplant patients)
2. electrolyte disturbances
3. seizures

drugs for CMV: ganciclovir, valganciclovir, foscarnet, cidofovir, fomivirsen
cidofovir
nucleoside analog
**converted by cellular enzymes to a Nucleotide DI-Phoshate!

chain terminator

**administered with probenecid which blocks its secretion
s/e: nephrotoxicity - (think renal transplant patients)

USE: CMV, CMV retinitis (use with ganciclovir)

drugs for CMV: ganciclovir, valganciclovir, foscarnet, cidofovir, fomivirsen
ribavirin
monophosphate dehydrogease inhibitor, blocking synthesis of dGTP. inhibits RNA polymerase of influenza virus

USES:
Influenza
RSV
chronic Hepatitis C virus (ribavirin + pegIFN 2 alpha b)
this is the only Rx recommended
LAMIVUDINE
* NRTI - works on HIV and HBV

nucleoside analog. chain terminator

HIV & HBV drug. emtricitabine and lamivudine are similar. DONT USE TOGETHER

USES:
HIV
hepatitis B

low cytotoxicity (few side effects)

Hep B = ALEE
adefovir
lamivudine
entacavir
emtricetabine
emtricitabine
* NRTI - works on HIV and HBV

nucleoside analog. chain terminator

HIV & HBV drug. emtricitabine and lamivudine are similar. DONT USE TOGETHER!

USES:
HIV
hepatitis B
adevofir dipivol
chain terminator

USE: hepatitis B
entacavir
nucleoside analog

USE: hepatitis B
Hep B = ALEE
adevofir
LAMIVUDINE
entacavir
emtricetabine
zanamivir
neuraminidase inhibitor

USE:
Influenza type A and B

give prophylactically to family member or <2 days after symptoms
oseltamivir
neuraminidase inhibitor

USE:
Influenza type A and B

give prophylactically to family member or <2 days after symptoms
enfuvirtide
enFUvirtide is a FUSION INHIBITOR antiretroviral

it binds the gp41 (tm) and prevents conf changes
tenofovir
NRTI - new drug and very potent
zidovudine
* NRTI


DONT GIVE WITH stavudine!

a pregnancy monotherapy
didanosine
* NRTI

s/e: peripheral neuropathy
efavirenz
* nNRTI (only 2 of these)

efavirenz (fuck the virenz!)


teratogenic. do not give during pregnancy. use nevirapine instead (the other nNRTI)
s/e: hallucination dreams
rash / stevens johnsons!
nevirapine
* nNRTI

nevirapine (never a nucleotide) = nN

mostly to prevent mother -> child HIV transmission (monotherapy.)

never transmit HIV to a child.
lopinavir
lopinavir / r

protease inhibitor

dual PI therapy = ritonavir is given in a low dose mainly to inhibit CYP450 and increase levels of other protease inhibitors
ritonavir
protease inhibitor

can be given in a low dose to inhibit CYP450 and increase levels of other protease inhibitors
saquinavir
protease inhibitor
side fx of protease inhibitors
buffalo hump
peripheral lipodystrophy
elevated triglycerides, elevated total cholesterol
hyperglycemia / insulin resistance
stavudine
NTRI

known for peripheral neuropathy

DONT GIVE WITH zidovudine!
HAART NNTRI therapy
2 NTRI + NNTRI

NNTRI's: efavirenz and nevirapine

never eff dudes and you wont need these
HAART PI therapy
2 NTRI + PI