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53 Cards in this Set
- Front
- Back
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Anti Herpesvirus Drugs Inhibitors of viral replication - Nucleoside Analogs |
Idoxuridine - iodinated thymidine analogue Acyclovir - acyclic guanine nucleoside (lacks 3' OH group) Valacyclovir - L-valyl-ester prodrug of acyclovir Ganciclovir - acyclic guanine nucleoside with 3' hydroxymethyl group Valganciclovir - L-valyl-ester prodrug of gancyclovir |
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Side Effects of Valacyclovir |
topical use: mucosal irritation & abdominal pain oral use: nausea, vomiting, diarrhea, rash & headache |
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Side Effects of Valgancyclovir |
Bone marrow suppression (myelosuppression) Teratogenicity Headache, GI disturbance Neutropenia |
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Anti Herpesvirus Drugs Inhibitors of viral replication - non nucleoside analogs |
Foscarnet - inorganic pyrophosphate analog |
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Foscarnet Side Effects |
Nephrotoxicity Neurotoxicity (CNS) |
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Foscarnet Use |
CMV Acyclovir resistant HSV HZV |
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Anti Hepresvirus Drugs Inhibitors of viral replication - unknown mechanism of action |
Fomivirsen - 21 base phosphothioate oligonucleotide Targets RNA encoding for IE2 (regulatory protein of CMV) |
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Fomivirsen Use |
CMV retinitis |
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Fomivirsen Side Effects |
Iritis Vitritis Cataract Increased Ocular Pressure |
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Anti-Influenza Drugs Prevention of Uncoating |
Amantadine Ramantadine They block M2 transporter protein on viral membrane |
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Amantadine & Ramantadine Use |
Influenza Virus A |
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Amantadine & Ramantadine Adverse Effects |
Neurological Symptoms: light-headedness, insomnia, loss of appetite and nausea Loss of concentration |
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Anti-Influenza Drugs Prevention of Virus Release |
Oseltamivir Zanamivir These are analogs of sialic acid and they inhibit Neuraminidase |
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Oseltamivir & Zanamivir Side Effects |
Oseltamivir: Abdominal pain Zanamivir: Bronchospasm |
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Anti-HIV Drugs |
Inhibitors of Viral Binding and Fusion Nucleoside/ Nucleotide RT Inhibitors Non-Nucleoside/nucleotide RT Inhibitors Viral Integrase Inhibitors Viral Protease Inhibitors |
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Anti-HIV Drugs Inhibitors of Viral Binding & Fusion |
Maraviroc: Inhibits CCR5 and its binding to gp120 Enfuvirtide: Inhibits Fusion between gp41 and CD4 |
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Maraviroc Use |
CCR5 tropic HIV strains |
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Maraviroc Side Effects |
None |
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Maraviroc Resistance |
Shift from CCR5 to CXCR4 Mutation in gp120, which allows binding of virus even if Maraviroc is present |
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Enfuvirtide Use |
HIV-1 |
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Enfuvirtide Resistance |
Mutation of binding site for drug on gp41 |
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Enfuvirtide Side Effects |
At site of injection: erythema, induration & pain |
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Anti-HIV Drugs Nucleoside/Nucleotide RT Inhibitors |
Zidovuline; synthetic thymidine analog Stavudine Zalcitabine Lamivudine |
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NRTI Use |
HIV-1 and HIV-2 Active Inhibitors of viral RT. NRTIs are activated generally by phosphorylation to the triphosphate form by cellular enzymes. It then competes with cellular triphosphates, which are substrates for proviral DNA by viral RT. |
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NRTI Side Effects |
Anemia Granulocytopenia Myopathy Pancreatitis Peripheral neuropathy |
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Zidovuline Side Effects |
Fatigue Malaise Myalgia Anorexia Headache Insomnia Bone Marrow Suppression |
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Zidovuline Resistance |
Mutations in RT: Thymidine Analogue Mutations (TAMs) |
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Anti-HIV Drugs Non-Nucleoside/Nucleotide RT Inhibitors |
Efavirenz; binds to non-essential site distant from the enzyme catalytic site Nevirapine Delaviridine Etravirine Induce conformational change, which reduces the activity of the enzyme RT. |
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NNRTI Use |
HIV-1 |
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NNRTI Side Effects |
Rashes |
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Anti- HIV Drugs Integrase Inhibitors |
Raltegravir Inhibits integrase, which integrates HIV cDNA into cellular DNA. This blocks replication of HIV virus. |
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Raltegravir Side Effects |
Headache Nausea Asthenia Fatigue |
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Anti-HIV Drugs Protease Inhibitors |
Saquinavir Inhibit action of viral aspartyl- protease. Virus cannot assembly |
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Protease Inhibitor Side Effects |
Nausea Vomiting Diarrhea |
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Anti-Hepatitis Virus Drugs (Focus on Hepatitis C) |
Interferon (IFN) Ribavirin Direct Antiviral Agent (DAA) |
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Interferon (IFN) |
Cytokine with antiviral, immunomodulatory and antiproliferative activities |
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Interferon Effects I |
Inhibits Transcription Activates protein Mx which inhibits mRNA synthesis Inhibits Translation Activates methylase, which reduces mRNA cap methylation Activates Phosphodiesterase, which blocks tRNA function Activates Protein Kinase 1, which blocks eIL-2A function --> inhibits mRNA translation initiation |
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Interferon Effects II |
Inhibits Post-Translational Processing Inhibits glycosyltransferase, which reduces protein glycosylation Inhibits Virus Maturation inhibits glycosyltransferase, which reduces glycoprotein maturation Inhibition of Virus Release |
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Interferon Side Effects |
Acute Influenza Like Symptoms Depression Neurotoxicity Hypothyroidism & Thyroiditis Myelosuppression Granulocytopenia & Thrombocytopenia |
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IFN Use |
Chronic HCV Chronic HBV Multiple Sclerosis RA Respiratory syncytial virus (RSV) Kaposi Sarcoma in HIV |
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Ribavirin |
Purine Nucleoside analog with modified base and D-ribose sugar Inhibits viral mRNA synthesis |
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Ribavirin Side Effects |
Conjunctival Irritation Pulmonary Function Deterioration Fatigue, Cough, Rash, Nausea, Depresssion Teratogenicity |
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Direct Antiviral Agent (DAA) (requires 12 weeks of injections) |
Divided into: Protease Inhibitors Directed Inhibitors Polymerase Inhibitors |
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Summary Drugs for CMV |
Ganciclovir and Valganciclovir Foscarnet Fomivirsen (CMV retinitis) |
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Summary Drugs for HSV |
Acyclovir & Valacyclovir Foscarnet (for acyclovir resistant HSV) Idoxuridine (HSV keratitis) |
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Summary Drugs for HZV |
Foscarnet |
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Summary Drugs Influenza A Virus |
Amanatide and Rimanatide |
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Summary Drugs Influenza A and B |
Oseltamivir and Zanamivir |
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Summary CCR5-tropic HIV strains |
Maraviroc |
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Summary HIV-1 Drugs |
Enfuvirtide NNRTI --> Efavirenz / Nevirapine/ Etravirine |
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Summary HIV-1 and HIV-2 Drugs |
NRTIs --> Zidovuline Integrase Inhibitors --> Raltegravir Protease Inhibitors --> Saquinavir |
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RNA Viruses |
Rubella Virus Rhabdovirus Arenavirus Piornavirus Coronavirus Flavivirus Orthomyxovirus Paramyxovirus |
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DNA Viruses |
Poxvirus Herpesvirus Adenovirus Hepadnavirus Papillomavirus |
