Ass. 34 - Pharm Ch 9

Front 1

How do most antiviral drugs work?

Back 1

Interfere with DNA synthesis and/or viral transcription processes

-get P into a triP (mimic nucleotide triphosphates)

Front 2

What is the MOA of Amantadine?

Back 2

Impairs uncoating of virus
-binds to influenza A M2 matrix and prevents fusion to cellular lysosomal membranes

Front 3

Amantadine is used to tx?

Back 3

Influenza A

(w/i 48 hr of symptom onset)
(Rimantadine works same way)

Front 4

MOA Interferon

Back 4

Induces host cell responses that inhibit viral RNA translation

Induces MHC-1 expression (increases cells sensitivity)

Front 5

Interferon is used to tx?

Back 5

-chronic HBV
-chronic HCV
-Hairy cell leukemia

Front 6

MOA Ribavirin

Back 6

mimics GTP

-blocks viral mRNA synthesis

Front 7

Ribavirin used to tx?

Back 7

Chronic HCV

(standard tx - peg-INF & ribavirin)

Front 8

MOA Acyclovir

Back 8

mimics GTP

-inhibits DNA Poly --> premature DNA chain termination
(DNA synthesis inhibitor)

Front 9

What is unique about the MOA of Acyclovir?

Back 9

Requires a viral thymidine kinase for P which is only present in select viruses

Front 10

Acyclovir used to tx?

Back 10

HSV-1
HSV-2
VZV
EBV

(Valacyclovir similar with longer 1/2 life)

Front 11

Does acyclovir penetrate the BBB?

Back 11

Yes

Front 12

MOA Vidarabine

Back 12

mimics ATP

-inhibits DNA synthesis

Front 13

Vidarabine used to tx?

Back 13

All herpes grp viruses
**2nd line ointment - herpes keratitis

(esp. herpes encephalitits & VZV in immunocompromised pt)

Front 14

MOA Ganciclovir

Back 14

(similar to acyclovir, but doesn't require viral thymidine kinase)

-mimics GTP --> inhibits DNA Poly --> early DNA chain termination

Front 15

Ganciclovir used to tx?

Back 15

CMV retinitis (typically in combo with valganciclovir)

Front 16

SE Ganciclovir

Back 16

Bone marrow suppression

-neutropenia
-aplastic anemia

Front 17

MOA AZT (zidovudine)

Back 17

TTP analog --> inhibits DNA synthesis

(triP by human thymidine kinase)

Front 18

AZT used to tx?

Back 18

HIV

Front 19

What drug class does AZT belong to?

Back 19

Anti-retroviral

(nucleoside reverse transcriptase inhibitors)

Front 20

What are the protease inhibitors?

Back 20

Saquinavir
Ritonavir
Indinavir
Nelfinavir
Fosamprenavir

Front 21

MOA protease inhibitors

Back 21

Inhibit cleavage "giant" protein that HIV must cut for functional component (gag-pol-env)

Front 22

Protease inhibitors used for?

Back 22

HIV infection

Front 23

What are the non-nucleoside reverse transcriptase inhibitors (NNRTIs)?

Back 23

Nevirapine
Delavirdine
Efavirenz

Front 24

NNRTIs used to tx?

Back 24

HIV infection

Front 25

MOA of fusion inhibitor?

Back 25

prevents fusion of HIV virion and cell via binding to gp41

Front 26

Approved fusion inhibitor?

Back 26

enfuvirtide

Front 27

SE of fusion inhibitor

Back 27

-increases risk bacterial pneumonia
-common: insomnia, HA, N
-severe hypersensitivity possible

Front 28

MOA integrase inhibitor

Back 28

inhibit HIV viral integrase enzyme --> preventing integration and insertion of HIV DNA into human DNA

Front 29

Approved integrase inhibitor

Back 29

Raltegravir

Front 30

MOA CCR5 antagonists

Back 30

-block CCR5 R on WBC (target for HIV)
--> prevents entry of virus into cell

Front 31

Approved CCR5 antagonist

Back 31

Maraviroc

Front 32

SE CCR5 antagonist

Back 32

Hepatotoxic

Front 33

MOA neuraminidase inhibitors

Back 33

Inhibit influenza virus neuraminidase

Front 34

Approved neuraminidase inhibitors

Back 34

Zanamivir
Oseltamivir

Front 35

Neuraminidase inhibitors used to tx

Back 35

Influenza A & B

Front 36

SE neuraminidase inhibitor - Zanamivir

Back 36

Bronchospasm

(not recommended if pt has lung dz)

Front 37

MOA Foscarnet

Back 37

Direct inhibitor of DNA poly & reverse transcriptase

Front 38

Foscarnet used to tx

Back 38

alt: CMV
alt: acyclovir & ganciclovir-resistant VZV & HSV
HIV (not part of HAART regimen)

Front 39

SE Foscarnet

Back 39

Nephrotoxic

Front 40

Valganciclovir used to tx

Back 40

In combo with ganciclovir for CMV retinitis

Front 41

SE Valganciclovir

Back 41

Bone marrow suppression

(Contraindicated in pt with ganciclovir allergy)

Front 42

MOA Trifluridine

Back 42

mimics TTP --> inhibits viral DNA synthesis

(does not require viral thymidine kinase)

Front 43

Trifluridine used to tx

Back 43

HSV
**DOC - Herpes-keratitis (solution form)

Front 44

MOA Cidofovir

Back 44

suppresses viral replication via inhibition viral DNA synthesis

Front 45

Cidofovir used to tx

Back 45

alt: CMV retinitis
DOC: smallpox & severe adenovirus

Front 46

SE Cidofovir

Back 46

Nephrotoxic --> Fanconi syndrome

(given with Probenecid to decrease dose)

TERATOGENIC