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105 Cards in this Set
- Front
- Back
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smallest form of life
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viruses
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t/f
viruses are not parasites |
f
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viruses rely on -- for replication
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host
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viruses
difficult to target |
"collateral damage"
have to destroy host cell also |
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t/f
viruses encodes for many proteins |
f
few nucleocapsid polymerase receptor |
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t/f
viral infections not immediately detected |
t
because immune system not activated by unique components of pathogen e.g. endotoxins of bacteria stimulate immune system |
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what overwhelms antiviral tx
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massive proliferation
ebola zaire virus can cause death in 5 days |
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virus --- host cells
decreased ---- response hard to distinguish host from ----- |
hijacks
immune pathogen |
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rapid viral -----
high -- rate of virus massive numbers of --- ----- |
evolution
mutation virus particles |
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viruses are highly ---
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infectious
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what's involeved in getting virus into cell
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hemaglutin
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what's involved in getting viruses out of the cell
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neuroamidases
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3 types of viruses
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dna
rna retroviruses |
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which viruses are double stranded
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dna
retrovirusues |
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2 ways for dna and rna to exist
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+
- |
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when will there be a - RNA template
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when the RNA is + to begin w/
vice versa |
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approaches to antiviral tx:
block viral --- to cells block ----- inhibit ---/--- synthesis |
attachment
uncoating dna/rna |
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appraoches to tx:
inhibit ---- ----synthesis approaches to antiviral tx inhibit specific --- ----- inhibit viral ----- |
viral protein
viral enzymes assembly |
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approaches to antiviral tx
inibit viral ---- stimulate host ---- ---- |
release
immune system |
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type 1 herpes simplex found in the
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mouth
face skin espophagus brain |
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type 2 herpes simplex found
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genitals
rectum hands meninges |
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varicella zoster causes
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chickenpox
shingles |
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cytomegalovirus causes
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retinitis
esophagitis colitis |
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trifluridine/idoxuradine
--- analogs, added into viral dna by ----, can't add next ---- ----- |
thymidine
polymerase base pair |
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trifluridine/idoxuradine used for --- due to herpes simplex
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keratoconjunctivitis
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trifluridine/idoxuradine route
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opthalmic ointment
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trifluridine/idoxuradine doesn't have appropriate -- group to put on the next base pair
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OH
so DNA synthesis stops there |
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ae of trifluridine/idoxuradine
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burning
itching mild irritation of eye |
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guanine analogs:
--- converted to acyclovir famciclovir converted to ------- valgaciclovir HCl converted to ------ |
valacyclovir
penciclovir ganciclovir Na |
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acyclovir/valacyclovir is a -- analog
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guanine
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guanine analogs lacking --- ---
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sugar moiety
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acyclovir/valacyclovir
selectivelyphosphorylated by viral ----- ----- added to viral dna |
thymidine kinase
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acyclovir/valacyclovir:
lack of --- ---- prevent elongation of dna |
sugar moiety
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indications for acyclovir/valacyclovir
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herpes simplex
varicella-zoster |
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resistance of acyclovir/valacyclovir due to
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altered thymidine kinase
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which has better bioavailability
acyclovir/valacyclovir |
valacyclovir
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gi se of acyclovir/valacyclovir
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n/v
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for acyclovir/valacyclovir
maintain |
hydration
crystallize in renal tubule |
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cns se of acyclovir/valacyclovir
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seizures
delirum tremor |
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t/f
acyclovir/valacyclovir can cause a rash |
t
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acyclovir/valacyclovir can cause ----- suppression
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bone marrow
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what can decrease renal CL of acyclovir/valacyclovir
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probenecid
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when should acyclovir/valacyclovir be given?
will it cure |
w/in 1st 24 hrs
shortens illness but doesn't cure infection |
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penciclovir/famciclovir similar moa as
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acyclovir
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penciclovir/famciclovir used to tx
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hsv
vzv |
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actions and toxicity of penciclovir/famciclovir similar to
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acyclovir
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which has better bioavailability
penciclovir/famciclovir |
famciclovir (prodrug)
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ganciclovir/valganciclovir
guanine analog inhibits similar to: |
acyclovir
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indications for ganciclovir/valganciclovir
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cmv in transplant
immunocompromised pt |
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which is more bioavailable:
ganciclovir/valganciclovir |
valganciclovir
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ae of ganciclovir/valganciclovir
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neutropenia
thrombocytopenia cns |
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cns se of ganciclovir/valganciclovir
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confusion
ataxia seizures coma |
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foscarnet is a --- derivative
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pyrophosphate derivative
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foscarnet inhibits viral ---- polymerase
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dna
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route of foscarnet
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iv
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adjust dose of foscarnet for:
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renal fx
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foscarnet is --- toxic
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nephro
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foscarnet --- cations:
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chelates
hypocalcemia hypomagnesia hypokalemia |
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indications for foscarnet
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cmv retinitis
acyclovir resistant hsv and shingles ganciclovir resistant cmv |
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ae foscarnet
cns |
ha
seizures fatigue tremor hallucinations |
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foscarnet can cause --- impairment
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renal
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resp effects due to foscarnet
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cough
dyspnea pneumothorax (due to cough) |
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t/f
foscarnet can cause a rash and fever |
t
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blood effects of foscarnet
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anemia
thrombocytopenia bleeding |
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amatadine and rimantidine can be used against the --- -----
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flu virus
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amatadine and rimantidine block the uncoating of flu ____, not effect against flu _____-
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Flu A
Flu B |
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amatadine and rimantidine will alter the ----- in endosome to prevent uncoating of --- material
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pH
viral |
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amatadine and rimantidine --- available
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oral
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frequency of dose of amatadine and rimantidine
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1-2 x day for 5-7 days
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what can control flu in institutionalized elderly pts
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amatadine and rimantidine
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ae of amatadine and rimantidine:
-- disturbances cns: |
gi
anxiety insomnia hallucinatins ha |
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which drug has less cns se?
why |
rimantidine
less lipid soluable |
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who's more prone to cns se of amatadine and rimantidine
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elderly
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selective inhbitors of viral neuraminadase
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oseltamivir
zanamivir |
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neuramindase is an enzyme involved in release of virus from cels and causes --- ------- at cell surface and prevents infection of ---- -----
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viral aggregation
respirtory cells |
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oseltamivir/ zanamivir
routre |
oseltamivir: oral tabs/suspension
zanamivir: dry powder inhaler |
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indications for oseltamivir/ zanamivir
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tx and prophylaxis of influ A and B in adules and kids > 12 months
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ae of oseltamivir/ zanamivir
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gi upset (tamiflu)
abd discomfort (tamiflu) wheezing/bronchospasm (not recommended for underlying airway disease) |
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ribavirin: modified ---- base w/ d-riboe sugar
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purine
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routes fo ribavirin
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oral
iv inhalation |
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ribavirin effective against:
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adenovirus
colorado tick virus hep b and c herpes virus mumps virus rift valley virus yellow fever virus hantavirus crimean-congo hemorrhagic virus resp synctial virus |
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ribavirin inhibits viral ---- ------ synthesis
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messenger rna
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resp synctial virus mainly seen in kids and immune suppresed pts . . . use
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ribavirin
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what do you give for hep c
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ribavirin + interferon alpha 2a or 2b
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ae of ribavirin:
cardiac ----- ---tension apnea -- spasm ---- tertogenic in animals |
cardiac arrest
hypotension apnea bronchospasm seizures . . .use contraceptives for 6 mo after tx |
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hep b and c
use |
interfron alpha
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interferon alfa is --- interferon alpha
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recombinant
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interferon alfa used against
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hep b
hep c papillomavirus |
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interferon alfa has anti ------ and --- actions, increased -----
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antiproliferative
modulating actions phagocytes |
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route of interferon alfa
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im
subq 3x weeks for 12 months . . . some 18-24 months |
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ae of interferon alfa
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fever/chills
flu like symptoms |
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ae of interferon alfa
cardiac |
hypotension
cp arrhythmias |
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ae of interferon alfa
blood and gi prob |
leukopenia
thrombocytopenia gi disturbances |
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interferon alfa
caution w/ |
pul disease
dm coagulation disorders |
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interferon CI in
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pregnancy
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lamivudine inhibits dna ---/------ in ----
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polymerase/reverse transcriptase
HBV |
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lamivudine used in hbv in --- and ------
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adults
kids |
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how long to use lamivudine for
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1 year
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lamivudine normalizes ---- ------
reduces hepatic ---- |
liver enzymes
hepatic inflammation |
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adefovir is an -- analog
prodrug inhibits viral dia ---- and --- ---- |
adenosine
polymerase reverse transcriptase |
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t/f
long tx of adefovir cures |
f
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ae of adefovir
-- toxicity --- ---dysfunction --- --- discomfort --- at lower doses |
nephrotoxicity
renal tubular dysfunction ha abd discomfort diarrhea |
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lamivudine
---- liver enzymes reduce hepatic ---- |
normalizes (40%)
inflammation (50%) |
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adefovir is an ---- analog
prodrug inhibits dna -- and ----- |
adenosine
polymerase reverse transcriptase |
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what do you give for hep b lamivudine resistant hbv
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adefovir
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