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41 Cards in this Set
- Front
- Back
- 3rd side (hint)
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The difference between Amantadine and Rimantadine.
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amantadine - renal elimination
rimantadine - hepatic elimination |
A-R
R-H |
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Anti-Viral with amphetamine like actions.
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amantadine
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Indication for amantadine and rimantadine.
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Influenza A and C prevention
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If you were on speed (amphetamine like action of amantadine) you would need AC.
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Mechanism of amantadine and rimantadine.
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phase one inhibitor disrupting viral uncoating and assembly of viral components.
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would require a coated virus
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indication for zanamavir and oseltamivir
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influenza A and B treatment
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What is the mechanism of zanamavir
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competitive inhibitor of neuraminidase
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amivir (anti influenza)
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Oseltamivir mechanism of action
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comeptitive inhibitor of neuraminidase
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amivir
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Acyclovir and Valacyclovir mechanism
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LETHAL SYNTHESIS required
inhibits viral DNA synthesis requires viral enzymes |
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Cidofovir mechanism
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LETHAL SYNTHESIS required
slows or stops DNA polymerase activity requires HOST enzymes ONLY (decreases selectivity) |
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Black Box Warning for Cidofovir
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probenecid slows uptake into proximal tubule reducing toxicity
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Fomivirsen Indication
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CMV retinitis in AIDS patients
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tx of last resort
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Foscarnet mechanism
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NO lethal synthesis required
Faster but not better inhibits reverse transcriptase |
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Black Box warning for Foscarnet
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renal toxicity (don't use with other nephrotoxic drugs even acyclovir), seizures
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Mechanism of action for Ganciclovir and Valganciclovir
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similar to acyclovir
LETHAL synthesis required inhibits viral DNA synthesis |
MORE POWER
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Contraindication for Ribavirin
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sickle cell anemia - hemolytic anemia
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Mechanism for Ribavirin
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increases RNA virus mutation rate
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Adverse reactions from Ribavirin
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hemolytic anemia (no in sickle cell anemia)
mutagenic, teratogenic, embryotoxic (birth control for either MEN OR WOMEN for months following use) |
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Ribavirin inhibits _________
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zidovudine
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RzS
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Zidovudine inhibits _________
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stavudine
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RzS
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Common vitamin supplementation during Zidovudine (AZT) therapy
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B12 also whole blood
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Class that includes:
Zidovudine (AZT) Stavudine Didanosine Lamivudine Abacavir |
Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
inhibit viral life cycle following lethal synthesis to nucleotide analog |
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NRTI considered to have the highest toxicity
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stavudine
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notable adverse effect of didanosine
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pancreatitis
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NRTI anti-viral containing phenylalanine
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Didanosine
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Best tolerated NRTI.
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Lamivudine
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Platinum Standard
Gold Standard is AZT |
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Hypersensitivity with this NRTI.
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abacavir
(abra cadabra you have sensitivity) |
abra cadabra you have sensitivity
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The only nucleotide reverse transcriptase inhibitor you need to know.
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Tenofovir
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When is Tenofovir helpful (It is a NTRTI)
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In a patient with NRTI resistant HIV
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What is a common side effect of non nucleoside reverse transcriptase inhibitors (NNRTI)?
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rash - sometimes severe
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Efavirenz and Nevirapine are in what class of anti-HIV drugs?
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NNRTIs
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Nevirapine is pregnancy category ___.
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Pregnancy Categore "D"
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Central toxicity is noted in about 50% of patients taking this NNRTI.
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Efavirenz
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Protease inhibitors (-navir) work by?
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Inhibiting HIV aspartic protease enzyme
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Oral preps of protease inhibitors (-navir) contain propylene glycol, what 4 drugs would you not want to give them (antibiotics)?
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Metronidazole
Cefotetan Cefoperazone Cefamandole |
disulfiram like reaction!
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Notable drugs you can't use with atazanavir.
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H2 blockers, antacids, PPIs
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acid problem
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Most potent CYP3A4 inhibitor of protease inhibitor class.
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ritonavir
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Metabolic problems with protease inhibitors (-navir)?
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hyperlipidemia (use statins)
hyperglycemia |
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Why do you use Lopinavir and Ritonavir together (not for decreased resistance)?
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ritonavir inhibits CYP3A4 preventing inactivation of Lipinavir
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Mechanism of Enfuvirtide
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fusion inhibitor
subq injections |
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Maraviroc mechanism
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CCR5 receptor blocker
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Raltegravir mechanism and main adverse reaction
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HIV integrase strand transfer inhibitor
RHABDOMYOLYSIS (no statin use) |
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