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46 Cards in this Set

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How do most antiviral drugs work?
Interfere with DNA synthesis and/or viral transcription processes

-get P into a triP (mimic nucleotide triphosphates)
What is the MOA of Amantadine?
Impairs uncoating of virus
-binds to influenza A M2 matrix and prevents fusion to cellular lysosomal membranes
Amantadine is used to tx?
Influenza A

(w/i 48 hr of symptom onset)
(Rimantadine works same way)
MOA Interferon
Induces host cell responses that inhibit viral RNA translation

Induces MHC-1 expression (increases cells sensitivity)
Interferon is used to tx?
-chronic HBV
-chronic HCV
-Hairy cell leukemia
MOA Ribavirin
mimics GTP

-blocks viral mRNA synthesis
Ribavirin used to tx?
Chronic HCV

(standard tx - peg-INF & ribavirin)
MOA Acyclovir
mimics GTP

-inhibits DNA Poly --> premature DNA chain termination
(DNA synthesis inhibitor)
What is unique about the MOA of Acyclovir?
Requires a viral thymidine kinase for P which is only present in select viruses
Acyclovir used to tx?
HSV-1
HSV-2
VZV
EBV

(Valacyclovir similar with longer 1/2 life)
Does acyclovir penetrate the BBB?
Yes
MOA Vidarabine
mimics ATP

-inhibits DNA synthesis
Vidarabine used to tx?
All herpes grp viruses
**2nd line ointment - herpes keratitis

(esp. herpes encephalitits & VZV in immunocompromised pt)
MOA Ganciclovir
(similar to acyclovir, but doesn't require viral thymidine kinase)

-mimics GTP --> inhibits DNA Poly --> early DNA chain termination
Ganciclovir used to tx?
CMV retinitis (typically in combo with valganciclovir)
SE Ganciclovir
Bone marrow suppression

-neutropenia
-aplastic anemia
MOA AZT (zidovudine)
TTP analog --> inhibits DNA synthesis

(triP by human thymidine kinase)
AZT used to tx?
HIV
What drug class does AZT belong to?
Anti-retroviral

(nucleoside reverse transcriptase inhibitors)
What are the protease inhibitors?
Saquinavir
Ritonavir
Indinavir
Nelfinavir
Fosamprenavir
MOA protease inhibitors
Inhibit cleavage "giant" protein that HIV must cut for functional component (gag-pol-env)
Protease inhibitors used for?
HIV infection
What are the non-nucleoside reverse transcriptase inhibitors (NNRTIs)?
Nevirapine
Delavirdine
Efavirenz
NNRTIs used to tx?
HIV infection
MOA of fusion inhibitor?
prevents fusion of HIV virion and cell via binding to gp41
Approved fusion inhibitor?
enfuvirtide
SE of fusion inhibitor
-increases risk bacterial pneumonia
-common: insomnia, HA, N
-severe hypersensitivity possible
MOA integrase inhibitor
inhibit HIV viral integrase enzyme --> preventing integration and insertion of HIV DNA into human DNA
Approved integrase inhibitor
Raltegravir
MOA CCR5 antagonists
-block CCR5 R on WBC (target for HIV)
--> prevents entry of virus into cell
Approved CCR5 antagonist
Maraviroc
SE CCR5 antagonist
Hepatotoxic
MOA neuraminidase inhibitors
Inhibit influenza virus neuraminidase
Approved neuraminidase inhibitors
Zanamivir
Oseltamivir
Neuraminidase inhibitors used to tx
Influenza A & B
SE neuraminidase inhibitor - Zanamivir
Bronchospasm

(not recommended if pt has lung dz)
MOA Foscarnet
Direct inhibitor of DNA poly & reverse transcriptase
Foscarnet used to tx
alt: CMV
alt: acyclovir & ganciclovir-resistant VZV & HSV
HIV (not part of HAART regimen)
SE Foscarnet
Nephrotoxic
Valganciclovir used to tx
In combo with ganciclovir for CMV retinitis
SE Valganciclovir
Bone marrow suppression

(Contraindicated in pt with ganciclovir allergy)
MOA Trifluridine
mimics TTP --> inhibits viral DNA synthesis

(does not require viral thymidine kinase)
Trifluridine used to tx
HSV
**DOC - Herpes-keratitis (solution form)
MOA Cidofovir
suppresses viral replication via inhibition viral DNA synthesis
Cidofovir used to tx
alt: CMV retinitis
DOC: smallpox & severe adenovirus
SE Cidofovir
Nephrotoxic --> Fanconi syndrome

(given with Probenecid to decrease dose)

TERATOGENIC